Experiencing integration: a qualitative pilot study of consumer and provider experiences of integrated primary health care in Australia.
Michelle Banfield, Tanisha Jowsey, Anne Parkinson, Kirsty A Douglas, Paresh Dawda
Author Information
Michelle Banfield: Centre for Mental Health Research, Research School of Population Health, The Australian National University, 63 Eggleston Rd, Acton, ACT 2601, Australia. Michelle.Banfield@anu.edu.au. ORCID
Tanisha Jowsey: Centre for Medical and Health Sciences Education The University of Auckland, Auckland City Hospital, Building 599, Level 12, Auckland, 1023, New Zealand.
Anne Parkinson: Department of Health Services Research and Policy, Research School of Population Health, The Australian National University, 63 Eggleston Rd, Acton, ACT 2601, Australia.
Kirsty A Douglas: ANU Medical School, Canberra Hospital, Bldg 4, Level 2, Garran, ACT 2605, Australia.
Paresh Dawda: Ochre Health Medical Centre, Cnr Allawoona Street & Ginninderra Drive, Bruce, ACT 2617, Australia.
BACKGROUND: The terms integration and integrated care describe the complex, patient-centred strategies to improve coordination of healthcare services. Frameworks exist to conceptualise these terms, but these have been developed from a professional viewpoint. The objective of this study was to explore consumers' and providers' concepts, expectations and experience of integrated care. A key focus was whether frameworks developed from a professional perspective are effective models to explore people's experiences. METHODS: A qualitative pilot study was undertaken at one Australian multidisciplinary primary health care centre. Semi-structured interviews were conducted with consumers (N = 19) and staff (N = 10). Data were analysed using a framework analysis approach. RESULTS: Consumers' experience of integrated care tended to be implicit in their descriptions of primary healthcare experiences more broadly. Experiences related to the typologies involved clinical and functional integration, such as continuity of providers and the usefulness of shared information. Staff focused on clinical level integration, but also talked about a cultural shift that demonstrated normative, professional and functional integration. CONCLUSIONS: Existing frameworks for integration have been heavily influenced by the provider and organisational perspectives. They are useful for conceptualising integration from a professional perspective, but are less relevant for consumers' experiences. Consumers of integrated primary health care may be more focussed on relational aspects of care and outcomes of care.
