Since its inception in 2000 the International Journal of Integrated Care has documented the trends, developments and newest findings in the research, policy and practice of integrated care. As its subject matter has continuously evolved over the years, so have the articles we publish reflected the growing understanding of what integrated care is and what it isn’t. Some of the key learnings over the years have been that, while there are some common building blocks and elements, which are essential for integrated care, ultimately all frameworks and models need to be contextualized to local needs and resources. This contextualization should ideally happen with wide community and professional involvement.
In accordance with this approach, many definitions of integrated care have emerged, and IJIC does not endorse any one single definition as the ultimate answer. There are however some often-cited definitions, which represent IJIC’s understanding of integrated care, such as:
A definition based on the perspective of the person
“I can plan my care with people who work together to understand me and my carer(s), allow me control, and bring together services to achieve the outcomes important to me.” (National Voices 2013)
A health system-based definition
“The management and delivery of health services such that people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease-management, rehabilitation and palliative care services, through the different levels and sites of care within the health system, and according to their needs throughout the life course” (WHO 2015)
A whole-of-systems’ definition
“The search to connect the healthcare system (acute, primary medical and skilled) with other human service systems (e.g., long-term care, education and vocational and housing services) to improve outcomes (clinical, satisfaction and efficiency)” (Leutz 1999)
A decision-maker’s definition
“Initiatives seeking to improve outcomes for those with (complex) chronic health problems and needs by overcoming issues of fragmentation through linkage or coordination of services of different providers along the continuum of care.” (Nolte and Pitchforth 2014)
A process-based definition
“Integration is a coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment and collaboration within and between the cure and care sectors. The goal of these methods and models is to enhance quality of care and quality of life, consumer satisfaction and system efficiency for patients ... cutting across multiple services, providers and settings. [Where] the result of such multi-pronged efforts to promote integration [lead to] the benefit of patient groups [the outcome can be] called ‘integrated care’.“ (Kodner and Spreeuwenberg, 2002)
It is important within your submission to be clear which of these or other definitions of integrated are being applied. There is a plethora of literature available discussing the various principles and core elements of integrated care, which should inform your research, policy and practice, and be reflected in the chosen definition. As the editorial board of IJIC endorses the belief that all integrated care is local, context-specific variations on the main theme are a fact, which do not facilitate a universal definition of integrated care. However, while all the above perspectives and definitions are valid, ultimately it should be the aim of integrated care to support the first, person-centred definition and include a holistic understanding of health. This should be informed by related concepts, such as the social determinants of health, public health principles or the bio-psycho-social understanding of health.
The Editorial Board of IJIC believes that the primary purpose of integrated care should be to improve user and carer experiences, quality of care, cost effectiveness, and workforce experience since such issues give integrated care both a rationale and a common basis on which to judge its impact. Along these lines, there needs to be a clear problem statement, making explicit the context and the problem or challenge, which is being addressed. It is important for prospective authors to recognise that we distinguish between integration and integrated care, noting that the structures and processes that support organisational and service integration may not always result in the enhanced outcomes and user experiences intended with integrated care. Therefore, the manuscript needs to be explicit on the integration mechanisms, explaining in detail where integration is happening and how this supports integrated care (or not). This includes a clear description of what outcomes are expected and for whom. Unlike other journals, we are also interested in publishing “negative results”, ie projects and initiatives, which failed, as long as they are well described and have a sound analysis of why integration did not happen.
The complexity of integrated care is reflected in a broad spectrum of themes, and we recognize that countries are on very different levels of sophistication. It is therefore paramount to be clear on what the article adds to our knowledge and understanding of integrated care. This needs to be substantiated with a considered discussion of the literature, including grey literature.
Finally, the International Journal for Integrated Care has a global readership and reach. True to this, we aim at enhancing the knowledge exchange and transferability of lessons learned across systems and countries. Therefore, every article needs to have a clear relevance for an international audience. Explaining briefly the distinctive and relevant elements of the context in which it is being introduced will help international readers to engage with the learning.
In summary, the key questions, which the editors ask when making a decision are:
More specifically, we accept articles that focus on integrated care for populations or particular user groups (e.g. older people, or persons with an unspecified chronic or long-term care need) as well as for particular service areas or diseases (e.g. to people with diabetes, integration between health and education, implementation of inter-disciplinary teams). We are also interested in new research methodologies, such as action research or mixed methods approaches, which support the continuous evaluation of integrated care. For health economics of integrated care, we have our own topic editors to promote better quality studies. As most articles still focus on health care integration, we want to invite prospective authors to think outside healthcare, and encourage submissions, which include as many other sectors as seems appropriate, or with other sectors in the lead. We do not accept articles without involvement of users, carers or patients, unless a pertinent reason is given, why they were not included.
This list is neither complete nor exhaustive, but is meant to give an overview of the kind of articles which IJIC is interested in. In order to support your decision of whether IJIC is the right to journal to submit your manuscript to, please also look at the recent editions and the published articles.
National Voices. Think Local Act Personal. A narrative for person-centred coordinated care. May 2013, available for download here: https://www.nationalvoices.org.uk/publications/our-publications/narrative-person-centred-coordinated-care.
World Health Organisation. WHO global strategy on people-centred and integrated health services: Interim report. World Health Organization, Geneva 2015.
Leutz WN. Five laws for integrating medical and social services: lessons from the United States and the United Kingdom. Milbank Quarterly 1999;77(1):77–110.
Nolte E, Pitchforth E. What is the evidence on the economic impacts of integrated care? European Observatory on Health Systems and Policies, Copenhagen 2014.
Kodner D, Spreeuwenberg C. Integrated care: Meaning, logic, applications and implications – a discussion paper. International Journal of Integrated Care 2002;2(14), e12.