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Financial Mechanisms for Integrating Funds for Health and Social Care: An Evidence Review


  • Anne Mason

    (Centre for Health Economics, University of York, UK)

  • Maria Goddard

    (Centre for Health Economics, University of York, UK)

  • Helen Weatherly

    (Centre for Health Economics, University of York, UK)


Integrated care is often perceived as a solution for some of the major challenges faced by health and social care systems. In these systems, 20% of the population accounts for 80% of the expenditure on care [1]. These ‘high users’ are typically people with one or more long-term conditions and who have complex needs that straddle health and social care boundaries; the population includes, but is not limited to, older people. By coordinating care at the level of the individual, decision makers should in theory identify problems earlier in the care pathway and shift care closer to home, improve the patient experience, prevent or reduce avoidable hospital admissions and delayed discharges, improve health outcomes and reduce unnecessary duplication of care. However, empirical studies of integrated care systems suggest that the reality falls far short of these high expectations. While some evaluations have identified cost savings or improved outcomes, most find no significant benefits, and in those that do identify improvements, the effects are small.

Suggested Citation

  • 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.
  • Handle: RePEc:chy:respap:97cherp

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    References listed on IDEAS

    1. Hultberg, Eva-Lisa & Lonnroth, Knut & Allebeck, Peter, 2003. "Co-financing as a means to improve collaboration between primary health care, social insurance and social service in Sweden. A qualitative study of collaboration experiences among rehabilitation partn," Health Policy, Elsevier, vol. 64(2), pages 143-152, May.
    2. Maynard, A., 2014. "Contracting for Quality in the NHS," Monographs, Office of Health Economics, number 000073.
    3. Segal, Leonie & Dunt, David & Day, Susan E. & Day, Neil Atherton & Robertson, Iain & Hawthorne, Graeme, 2004. "Introducing co-ordinated care (1): a randomised trial assessing client and cost outcomes," Health Policy, Elsevier, vol. 69(2), pages 201-213, August.
    4. 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.
    5. Segal, Leonie & Dunt, David & Day, Susan E., 2004. "Introducing coordinated care (2): evaluation of design features and implementation processes implications for a preferred health system reform model," Health Policy, Elsevier, vol. 69(2), pages 215-228, August.
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    Cited by:

    1. Exworthy, Mark & Powell, Martin & Glasby, Jon, 2017. "The governance of integrated health and social care in England since 2010: great expectations not met once again?," Health Policy, Elsevier, vol. 121(11), pages 1124-1130.
    2. Wildman, John & McMeekin, Peter & Grieve, Eleanor & Briggs, Andrew, 2016. "Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators," Social Science & Medicine, Elsevier, vol. 169(C), pages 141-148.

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    Payment systems; pooled budgets; joint commissioning; integrated care; systematic review;
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