Table 2

Summary of included studies

Author(s) and publication year	Title	Country of study	Purpose	Study design characteristics	Participant characteristics	Definition of integrated care used in study
Algilani et al (2017)41	An interactive ICT platform for early assessment and management of patient-reported concerns among older adults living in ordinary housing—development and feasibility	Sweden	To develop and test feasibility and acceptability of an interactive ICT platform integrated in a tablet for collecting and managing patient-reported concerns of older adults in home care	Mixed-methods design combining interviews with older adults and healthcare professionals, and logged quantitative data	n=8 Swedish-speaking older adults registered in and receiving assistance and/or regular contact with a nurse in the healthcare system	None provided
Baillie et al (2014)20	Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: a qualitative case study	UK	To investigate care transitions of frail older people from acute hospital wards to community healthcare or community hospital wards, within a system that had vertically integrated acute hospital and community healthcare services	Multimethod qualitative study including individual interviews and focus groups	n=17 key hospital ward staff (GPs, adult community healthcare lead, district nurses, community physiotherapist, community occupational therapist); n=36 ward staff; n=4 older adults (75% female; age range 78–98 years) undergoing care transitions	‘Integration is the combination of methods, processes and models that aim to achieve integrated care, which is an organising principle for care delivery that aims to improve patient care through better coordination’
Bayliss et al (2008)21	Processes of care desired by elderly patients with multimorbidities	USA	To explore processes of care desired by elderly patients who have multimorbidities that may present competing demands for patients and providers	Qualitative design using individual interviews	n=26 non-for-profit Health Maintenance Organization members (50% female) aged 65–84 years	None provided
Berendsen et al (2009)22	Transition of care: experiences and preferences of patients across the primary/secondary interface—qualitative study	Netherlands	To explore the transition of care at the primary– secondary interface with reference to the impact of patients’ ability to make choices about their secondary care providers	Exploratory qualitative design with semistructured focus groups	n=71 Dutch patients who had been referred to a specialist within the past 2 years	None provided
Blom et al (2016)35	Effectiveness and cost-effectiveness of a proactive, goal-oriented, integrated care model in general practice for older people. A cluster randomised controlled trial: integrated systematic care for older people—the ISCOPE study	Netherlands	To assess the effectiveness and cost-effectiveness of a simple structural monitoring system to detect the deterioration in somatic, functional, mental or social health of individuals aged 75 and over followed by the execution of a care plan for those people with a combination of somatic, functional, mental and social problems	Observer-blinded cluster randomised controlled trial	n=7285 older adults with complex health problems attending general practices in Leiden, Netherlands	None provided
Burridge et al (2016)23	Making sense of change: patients' views of diabetes and GP-led integrated diabetes care	Australia	To investigate patients’ perceptions and experiences of type 2 diabetes, self-care and engagement with a GP-led integrated diabetes care model	Qualitative interviews, thematic analysis using normalisation process theory	n=30 older patients with type 2 diabetes	None provided
Cheng (2017)24	Emotions, significance and improvement expectations: the personal matter of a patient’s hospital stay	Canada	To learn about patients’ perspectives of hospital care to gain insights about the specifics of patient-centred care	Qualitative analysis of National Research Corporation Canada adult inpatient survey responses	n=1638 responses from patients and hospital discharges from 22 units	None provided
Cook et al (2017)42	Older UK sheltered housing tenants’ perceptions of well-being and their usage of hospital services	UK	To examine sheltered housing tenants’ views of health and well-being, the strategies they adopted to support their well- being and their use of health and social care services through a health needs assessment	Parallel, three-strand mixed- methods approach encompassing tenants’ perceptions of health and well-being, analysis of the service’s health and well-being database and analysis of emergency and elective hospital admissions	n=978 tenants living in sheltered housing	None provided
Cowie et al (2009)25	Experience of continuity of care of patients with multiple long-term conditions in England	UK	To examine patients’ experiences of continuity of care in the context of different long-term conditions and models of care, and to explore implications for the future organisation care of long-term conditions	Qualitative design with semistructured interviews	n=33 patients with multiple long-term conditions	Definition of ‘continuity of care’ provided
Derksen et al (2012)26	A local consensus process making use of focus groups to enhance the implementation of a national integrated health care standard on obesity care	Netherlands	To understand experiences and expectations of healthcare professionals and patients concerning opportunities and barriers for local overweight/obesity care	Exploratory qualitative study using focus groups and individual interviews	n=24 older adults living independently in Zwolle, Netherlands	‘Integrated care includes prevention, screening, diagnosis, treatment, relapse prevention and long term care’ no source. ‘The central aim of recent guidelines and integrated health standards is the organisation of patient oriented care and the support of patients' self management’
Ebrahimi et al (2017)36	Effects of a continuum of care intervention on frail elders’ self-rated health, experiences of security/safety and symptoms: a randomised controlled trial	Sweden	To evaluate the effects of the intervention on self-rated health, experiences of security/safety and symptoms	Non-blinded controlled trial	n=161 frail older adults at high risk of further care consumption	None provided
Freeman and Hughes (2010)47	Continuity of care and the patient experience: an inquiry into the quality of general practice in England	UK	To examine continuity of care in general practice, with a particular emphasis on understanding ‘good continuity’ from the patient’s point of view, considering the different types of continuity distinguished by researchers and their relationship to other aspects of quality in primary care, and assessing the state of the art of measuring continuity of care	Mixed-methods design involving a search of published research and other relevant documents, following up leads from key sources and individual interviews with GPs and other members of practice teams	n=3 practice managers, n=8 GPs (including partners and trainees), n=6 receptionists and n=2 nurses	Definition of ‘continuity of care’ provided
Hepworth et al (2013)27	‘Working with the team’: an exploratory study of improved type 2 diabetes management in a new model of integrated primary/secondary care	Australia	To explore how a new model of integrated primary/secondary care for type 2 diabetes management related to improved diabetes management in a selected group of patients	Qualitative research design with semistructured interviews and critical case sampling	n=10 patients with type 2 diabetes attending the Brisbane South Complex Diabetes Service	None provided
Jackson et al (2012)28	Patient journey: implications for improving and integrating care for older adults with chronic obstructive pulmonary disease	Canada	To summarise the experiences of four patients with COPD as they interacted with the healthcare system over a 3-month period following hospital discharge, with a view to informing the development of a more integrated approach to service delivery and improved quality of care	Case study methodology using semistructured interviews and patients’ logs	n=3 older adults with a primary or secondary diagnosis of COPD who were discharged home or to seniors’ housing	‘Principles to achieve a fully integrated health system…include (a) comprehensive services across the care continuum; (b) patient focus; (c) geographic coverage and rostering; (d) standardized care delivery through interprofessional teams; (e) performance management; (f) information systems; (g) organizational culture and leadership; (h) physician integration; (i) governance structure; and (j) financial management’
Jeon et al (2010)29	Achieving a balanced life in the face of chronic illness	Australia	To develop an in-depth understanding of the experience of patients and family carers affected by chronic illness that will be the basis on which to propose policy and health system interventions that are patient centred	Qualitative design with semistructured in-depth interviews	n=52 patients (46% female, 67% aged ≥65 years, 21% Indigenous Australians, 21% culturally and linguistically diverse (CALD)) and n=14 carers (93% female, 50% aged ≥65 years, 0% Indigenous, 36% CALD)	None provided
Johnston et al (2009)43	Designing and testing a web-based interface for self-monitoring of exercise and symptoms for older adults with chronic obstructive pulmonary disease	USA	To describe our process of developing a set of integrated tools to support collaborative symptom and exercise monitoring for patients with chronic obstructive pulmonary disease (COPD) who may be experiencing breathing difficulties	Mixed-methods four-phase design involving semistructured interviews, a targeted review of publicly available self-monitoring tools, software development and field usability testing	n=14 patients with COPD	None provided
Jubelt et al (2014)37	Patient ratings of case managers in a medical home: associations with patient satisfaction and health care utilization	USA	To measure the association of patient perceptions of patient-centred medical home case manager performance with overall satisfaction and subsequent healthcare utilisation	Retrospective cohort study of patients within an integrated healthcare system	n=1415 patients with clinically complex conditions	None provided
Liss et al (2011)38	Patient-reported care coordination: associations with primary care continuity and specialty care use	USA	To investigate the association between care coordination and continuity of primary care and differences in this association by level of specialty care use	Cross-sectional study involving survey information on patient experiences and automated healthcare utilisation data	n=2051 Medicare enrollees with select chronic conditions in an integrated healthcare delivery system in Washington State, USA	Definition of ‘continuity of care’ provided
National Voices (2012)48	Principles for integrated care	UK	To describe ‘success’ from the perspective of patients and to discuss measures of success	Report with literature review	NA	Integrated care mentioned but not defined
National Voices (2013)49	Integrated care: what do patients, service users and carers want?	UK	To summarise views of patients, service users and carers regarding what they want from integrated care, considering implications for education, training and public health	Report with literature review	NA	Integrated care mentioned but not defined
Osborn et al (2014)39	International survey of older adults finds shortcomings in access, coordination and patient-centred care	Eleven countries, including Australia, USA, UK, Canada, New Zealand	To assess how the health system performs, with a particular focus on access to care, chronic conditions and care coordination, patient engagement, social care needs and end-of-life care planning	Computer-assisted telephone interviews of nationally representative random samples in 11 countries	n=15 617 older adults aged ≥65 years contacted by market research firms via mobile and/or landline phone	None provided
Rimmer et al (2015)30	The design and initial patient evaluation of an integrated care pathway for faecal incontinence: a qualitative study	UK	To describe a novel integrated care pathway for the management of faecal incontinence (FI) and examine the experiences of patients with FI in relation to this pathway	Focus groups and narrative interviews	n=13 patients with FI	‘Integrated care pathways (ICPs) are multidisciplinary plans that predict the course of events in the treatment of patients with similar problems. The aim of an ICP is to enhance the quality of care by improving patient outcomes, promoting patient safety, increasing patient satisfaction and optimising the use of resources’
Roland et al (2012)44	Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation	UK	To report the outcome of intensive case management for older adults at risk of emergency hospital admission	Mixed-methods approach with preintervention and postintervention survey questionnaires sent to health and social care staff directly involved or impacted by the intervention; patient questionnaires; analysis of hospital utilisation using existing data, analysed by difference in differences analysis	n=460 patients who were part of the integrated care pilot who received the case management intervention and returned both pre/postquestionnaires	‘[Integrated care is intended] to achieve more personal, responsive care and better health outcomes for a local population’
Ryan et al (2013)45	Comparing patient and provider perceptions of home- and community-based services: social network analysis as a service integration metric	Canada	To examine and compare provider and patient perceptions of teamwork and collaboration among the home and community-based care providers in four case studies	Case study design involving social network visualisations	n=4 community-dwelling frail older adults	None provided
Sada et al (2011)31	Primary care and communication in shared cancer care: a qualitative study	USA	To explore the perceptions of primary care physicians and oncologists’ roles, responsibilities and patterns of communication related to shared cancer care in three integrated health systems that use electronic health records	Qualitative design with semistructured interviews	n=10 male patients with cancer	Definition of ‘shared care’ provided
Sharma (2014)40	Integrated care of the diabetic-oncology patient	USA	To measure the effect on emergency department, observation and hospital admissions for patients with cancer with diabetes who were seen by the Diabetic Oncology Program (DOP). A secondary aim included evaluation of patient satisfaction with care coordination and patient empowerment with diabetes self-management for the patients who were seen by the DOP.	Before and after study involving analysis of claims data of adult patients with cancer with diabetes before and after the DOP	n=98 patients with a diagnosis of cancer, historical or active hyperglycaemia, pre-diabetes, or any type of diabetes, attending hospital-affiliated oncology practices, under active treatment	Definition of ‘care coordination’ provided
Stevens (2014)46	An exploration of early palliative care in adult patients with cystic fibrosis and healthcare professionals	UK	To explore the experience and perceptions of patients with cystic fibrosis (CF) and staff regarding palliative care and the acceptability of this as a service early in the patient’s disease trajectory	Mixed-methods design involving a focus group, a national survey and patient interviews	n=8 patients with CF	‘Integrated care relates to principles for delivery of care that aims to improve the patient’s experience through improved coordination of care. Integration is the bringing together of methods, processes and models that help bring this about’
Toscan et al (2012)32	Integrated transitional care: patient, informal caregiver and health care provider perspectives on care transitions for older persons with hip fracture	Canada	To determine the core factors related to poorly integrated care when patients with hip fracture transition between care settings	Qualitative focused ethnographic study using individual interviews and repeated observations	n=6 patients aged ≥65 years with hip fracture with no cognitive impairment able to read and write in English; n=6 informal carers; n=18 healthcare providers involved in the admission or discharge of the patient	Definition of ‘continuity of care’ provided
Vat et al (2015)33	Reasons for returning to the emergency department following discharge from an internal medicine unit: perspectives of patients and the liaison nurse clinician	Canada	To understand patients’ reasons for returning to emergency department following hospitalisation	Qualitative descriptive approach with in-depth individual interviews	n=8 older patients with chronic illnesses	None provided
Wodskou et al (2014)34	A qualitative study of integrated care from the perspectives of patients with chronic obstructive pulmonary disease and their relatives	Denmark	To examine how patients with COPD and their relatives experience integrated care across care settings after the implementation of a COPD disease management programme	Qualitative design with focus groups and semistructured interviews	n=34 patients with COPD	None provided

GP, general practitioner; ICT, Information and Communication Technology; NA, not applicable.