Do integrated care structures foster processes of integration? A quasi-experimental study in frail elderly care from the professional perspective

OBJECTIVE: This study explores the processes of integration that are assumed to underlie integrated care delivery. DESIGN: A quasi-experimental design with a control group was used; a new instrument was developed to measure integration from the professional perspective. SETTING AND PARTICIPANTS: Professionals from primary care practices and home-care organizations delivering care to the frail elderly in the Walcheren region of the Netherlands. INTERVENTION: An integrated care intervention specifically targeting frail elderly patients was implemented. MAIN OUTCOME MEASURES: Structural, cultural, social and strategic integration and satisfaction with integration. RESULTS: The intervention significantly improved structural, cultural and social integration, agreement on goals, interests, power and resources and satisfaction with integration. CONCLUSIONS: This study confirms that integrated care structures foster processes of integration among professionals. TRIAL REGISTRATION: Current Controlled Trials ISRCTN05748494.