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An integrated health and social care organisation in Sweden: Creation and structure of a unique local public health and social care system


  • Øvretveit, John
  • Hansson, Johan
  • Brommels, Mats


Research and citizens have noted failures in coordinating health and social services and professionals, and the need to address this issue to realize benefits from increasing specialisation. Different methods have been proposed and one has been structural integration of separate services within one organisation. This paper reports an empirical longitudinal study of the development of an integrated health and social care organisation in Sweden combining service provision, purchasing and political governance for a defined population. The study found a combination of influences contributed to the development of this new organisation. The initial structural macro-integration facilitated, but did not of itself result in better clinical care coordination. Other actions were needed to modify the specialised systems and cultures which the organisation inherited. The study design was not able to establish with any degree of certainty whether better patient and cost outcomes resulted, but it did find structural and process changes which make improved outcomes likely. The study concludes that coordinated actions at different levels and of different types were needed to achieve care coordination for patients and that a phased approach was necessary where management capacity and outside expertise are limited.

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  • Øvretveit, John & Hansson, Johan & Brommels, Mats, 2010. "An integrated health and social care organisation in Sweden: Creation and structure of a unique local public health and social care system," Health Policy, Elsevier, vol. 97(2-3), pages 113-121, October.
  • Handle: RePEc:eee:hepoli:v:97:y:2010:i:2-3:p:113-121

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    References listed on IDEAS

    1. Yarnall, K.S.H. & Pollak, K.I. & Østbye, T. & Krause, K.M. & Michener, J.L., 2003. "Primary care: Is there enough time for prevention?," American Journal of Public Health, American Public Health Association, vol. 93(4), pages 635-641.
    2. Maria M. Hofmarcher & Howard Oxley & Elena Rusticelli, 2007. "Improved Health System Performance through better Care Coordination," OECD Health Working Papers 30, OECD Publishing.
    3. Mur-Veeman, Ingrid & van Raak, Arno & Paulus, Aggie, 2008. "Comparing integrated care policy in Europe: Does policy matter," Health Policy, Elsevier, vol. 85(2), pages 172-183, February.
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    2. Fadumo Noor & Gabriel Gulis & Leena Eklund Karlsson, 2022. "Users’ and Providers’ Perceptions about Integrated Health Care in Southern Denmark," Societies, MDPI, vol. 12(5), pages 1-19, September.
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    4. Anne Mason & Maria Goddard & Helen Weatherly, 2014. "Financial Mechanisms for Integrating Funds for Health and Social Care: An Evidence Review," Working Papers 097cherp, Centre for Health Economics, University of York.
    5. Mirjam Ekstedt & Marie Kirsebom & Gunilla Lindqvist & Åsa Kneck & Oscar Frykholm & Maria Flink & Carolina Wannheden, 2021. "Design and Development of an eHealth Service for Collaborative Self-Management among Older Adults with Chronic Diseases: A Theory-Driven User-Centered Approach," IJERPH, MDPI, vol. 19(1), pages 1-19, December.
    6. Janssen, Bienke M. & Snoeren, Miranda W.C. & Van Regenmortel, Tine & Abma, Tineke A., 2015. "Working towards integrated community care for older people: Empowering organisational features from a professional perspective," Health Policy, Elsevier, vol. 119(1), pages 1-8.
    7. Tuomas Korhonen & Virpi Sillanpää & Aki Jääskeläinen, 2023. "Anchor practices that guide horizontal performance measurement: an interventionist case study of the financial aspect of new technology implementation in healthcare," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 27(3), pages 787-816, September.
    8. Karatekin, Canan & Hong, Saahoon & Piescher, Kristine & Uecker, Jill & McDonald, Jeff, 2014. "An evaluation of the effects of an integrated services program for multi-service use families on child welfare and educational outcomes of children," Children and Youth Services Review, Elsevier, vol. 41(C), pages 16-26.

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