For service providers the espoused benefits include cost-effectiveness, reduction in length of hospital stay, reduction in inappropriate hospitalisation and decrease in admission to long-term care.Hence, the focus of attention has shifted from attempting to understand the problem to seeking to find ways to promote integration across the care system.
The project had been stimulated by the recognition that existing services fell short of providing appropriate, timely and co-ordinated care for older people.
There was a consensus that older people have complex and interacting needs, and they often require treatment and care from a range of professionals and carers, services and agencies at the same time.
In addition to concerns about the impact that these factors have on the quality of care that older people receive, there had been increasing awareness that they have an impact on the efficiency and effectiveness of the available services.
For example, an older person may have an extended period of hospitalisation resulting from difficulties in arranging the necessary services to support them in the community rather than their need for specialist in-patient care.
This literature review was designed to support and expand this activity, by providing a foundation for enquiry and analysis, identifying key concepts and definitions, and informing the development of the questions that the empirical study would seek to answer.
Discussions with the commissioning team identified a number of key issues that they wished to address.material which had not been reviewed for publication.Results: The study found that thinking has moved on from a focus on the problems of accessing services to exploring ways in which they may function in an integrated way.Key informants were identified by the research team through discussion with the commissioners and from their own networking.Material was retrieved from both electronic databases and from the grey literature.The study was commissioned by a group of service providers from health and social care in the same locality, who were beginning to work together in an integrated way to provide care for older people, a field beset by the historical divisions in the UK between health and social care, and between care and services, such as housing and transport.The empirical study collected data from staff and service-users to explore their experiences of care, and the ways in which integration had been developed.Purpose: This paper reports on some of the findings of a literature review commissioned to explore integrated care for older people.Methods: The process of revising included finding and selecting literature from multidisciplinary sources, and encompassed both published papers and ‘grey’ literature, i.e.Identifying and locating material was dependent on both expertise in retrieving and locating material through ‘insider knowledge’ [2] of the research team and the experts that they were able to consult, and expertise in using data searching tools and processes.Analysing the material was similarly dependant on understanding the different professional and policy developments, which the material reflected and referred to.
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