Measuring integrated care at the interface between primary care and secondary care: a scoping review.

Purpose: In many healthcare systems, health policy has committed to delivering an integrated model of care to address the increasing burden of disease. The interface between primary and secondary care has been identified as a problem area. This paper aims to undertake a scoping review to gain a deeper understanding of the markers of integration across the primary–secondary interface. Design/methodology/approach: A search was conducted of PubMed, SCOPUS, Cochrane Library and the grey literature for papers published in English using the framework described by Arksey and O'Malley. The search process was guided by the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA). Findings: The initial database search identified 112 articles, which were screened by title and abstract. A total of 26 articles were selected for full-text review, after which nine articles were excluded as they were not relevant to the research question or the full text was not available. In total, 17 studies were included in the review. A range of study designs were identified including a systematic review (n = 3), mixed methods study (n = 5), qualitative (n = 6) and quantitative (n = 3). The included studies documented integration across the primary–secondary interface; integration measurement and factors affecting care coordination. Originality/value: Many studies examine individual aspects of integration. However, this study is unique as it provides a comprehensive overview of the many perspectives and methodological approaches involved with evaluating integration within the primary–secondary care interface and primary care itself. Further research is required to establish valid reliable tools for measurement and implementation. [ABSTRACT FROM AUTHOR]