Integration and collaboration in public health—a conceptual framework

This paper considers the problems of interagency and interprofessional collaboration in community care in Great Britain from the combined perspectives of UK and US researchers. The research team drew on empirical and theoretical literature from both countries to construct a framework for analysing inter- and intra-organisational theories of joint working. This analysis, supplemented and supported by local case studies conducted by the researchers, generates a framework recommendation against which the government's initiatives for partnership working in the NHS plan 2000 and subsequently can be critically reviewed. In particular, at a time when structural integration--via Care Trusts--is being seriously considered, they highlight the vital importance of integrated systems of goal setting, authority and multidisciplinary service delivery rather than a narrow focus on structural integration alone.

Empirical evidence for the efficacy of interdisciplinary teams is essential in the current context of managed care. Because careful assessment of the interdisciplinary team has important implications for patients and health care professionals, as well as employers, the authors read over 2,200 abstracts and analyzed 224 articles from four databases in eight health-related fields. Articles were grouped by the type of analysis engaged in by their authors (descriptive, process-focused, empirical, or outcome), by methodology (none, general research, or quantitative), and by domains of interest (patient care, personnel, or management). Findings indicate significant weaknesses in terminology and research content. Directions for future research that would help ascertain the contribution of the interdisciplinary team are outlined.