Providing integrated health and social care for older persons: a European overview of issues at stake

Together with the exploration of different components of integration—care management, strategies for intermediate care, needs assessment and joint planning, user choice, integration of professional cultures, care-friendly communities, support for informal (family) care, quality management—this distillation from the specifics of different national strategies and from the detail of almost 50 pilot or mainstream projects begins to address the elements which may be seen as fundamental to the development of a theory of integrated care. In practical terms they address four key areas: an identification of the need for and the barriers to the provision of integrated care for older people in Europe; a discussion of the alternative definitions of integrated care which highlights the importance of a person-centred approach; an exploration of the alternative strategies for overcoming the barriers to integrated care; and a critical examination of alternative approaches to the evaluation of integrated care. If the second phase of this project, detailed case studies of model ways of working, can proceed to the identification of a robust and sustainable strategy for service delivery it will be a major advance.