Integrated delivery systems for health care in the USA are associated with positive effects on quality of care

Added May 10, 2020

Citation: Hwang W, Chang J, LaClair M, et al. Effects of integrated delivery system on cost and quality. American Journal of Managed Care 2013; 19: e175-84

What is this? The COVID-19 pandemic is placing a strain on healthcare services. Existing research on the effects of integrated healthcare delivery systems (which are organised and coordinated systems managed by a financial entity) may provide useful information for policy makers.

In this systemic review, the authors searched for research evaluating the effects of integrated delivery systems in the USA on healthcare costs and quality. They restricted their search to studies published between 2000 and 2011, which were specific to the health system in the USA. They identified 21 peer-reviewed and 4 non-peer reviewed articles, and impacts on cost were assessed in 8 of these (5 peer-reviewed, 2 non-peer reviewed).

What was found: Most studies showed an association between increased integration of healthcare systems in the USA and improvement in quality of care with respect to, for example, clinical effectiveness, length of stay, medication error, number of office visits, hospital admission rates and rates of adverse health outcomes; but it is uncertain whether the improvements are due to integration or to associated characteristics (e.g. greater use of electronic medical records and systematic quality improvement initiatives).

Several studies found that patients treated for chronic diseases at integrated delivery systems in the USA had better outcomes.

Several studies found improvements in preventative care in integrated delivery systems in the USA.

There was some evidence of lower healthcare costs in integrated delivery systems in the USA.

The evidence for lower healthcare costs in integrated delivery systems in the USA is weak.

 

Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.

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