CONCEPTUALIZING AND MEASURING INTEGRATION - FINDINGS FROM THE HEALTH-SYSTEMS-INTEGRATION-STUDY

Given the pressures for health care reform, interest in the concept of integrated or organized delivery systems as a means to offer more coo rdinated cost-effective care is growing. This article has two primary objectives: (1) to clarify the different types of integration associat ed with the notion of an organized delivery system, and (2) to share t he results from an ongoing study of 12 organized delivery systems. The findings indicate a moderate level of integration overall, particular ly in the areas of culture, financial planning, and strategic planning . The study found that corporate staff respondents perceive their syst ems to be more integrated and effective than do operating unit manager s, and that some functional integration areas are positively associate d with both physician-system and clinical integration that, in turn, a re positively related to each other. Overall, perceived integration wa s found to be positively associated with perceived effectiveness.