People with complex health needs require care from different providers across multiple healthcare settings. Therefore, they are at greater risk of receiving fragmented care. Countries have responded to this challenge by implementing patient-centred, integrated models of care designed to prevent and manage chronic diseases.

This report is part of the OECD’s work on promoting best practices in public health in OECD and EU27 countries. It aims to help countries improve care delivery by examining the potential to scale-up and transfer best practice integrated care models. Integrated care models reviewed as part of the report range from small pilots operating at the city level to nationwide programmes covering entire populations. Further, many case studies operate at a specific level of care, such as primary care, while others cover the whole spectrum of healthcare services.

Selected integrated care models were assessed against a validated performance framework outlined in the OECD Guidebook on Best Practices in Public Health. The framework includes five criteria namely effectiveness, efficiency, equity, the quality of the evidence-base, and the extent of coverage. The assessment also covered the potential to transfer integrated care models across countries.

Based on assessments of selected integrated care models, this report recommends several ways to reduce care fragmentation, including:

  • Strengthening governance structures by breaking down silos across administrative systems in health and social care with the support of key stakeholders

  • Exploring innovative payment models that encourage providers to deliver co-ordinated care

  • Investing in training programmes to teach health professionals new skills and supporting new professional roles, such as case managers

  • Implementing digital inclusion activities targeting vulnerable populations as well as promoting digital tools and health information systems

  • Strengthening the evidence-base supporting integrated care by measuring structural, process and outcome indicators specific to integrated care that are comparable across countries

  • Adapting integrated care models to the needs of vulnerable populations as well as investing in health literacy programmes to reduce health inequalities

  • Utilising existing frameworks that measure a region’s readiness to implement best practice integrated care models to facilitate their expansion, as well as promote close ties between owners and adopters of best practice models.

Metadata, Legal and Rights

This document, as well as any data and map included herein, are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area. Extracts from publications may be subject to additional disclaimers, which are set out in the complete version of the publication, available at the link provided.

© OECD 2023

The use of this work, whether digital or print, is governed by the Terms and Conditions to be found at