A Theory-driven evaluation of Integrated Health and Social Care Programs in the Apulia Region

Service delivery has traditionally developed in ways that have tended to fragment care. In the last decades, however, the growing numbers of people with complex needs (i.e. chronic conditions and multiple care needs) have required the development of delivery systems that bring together a range of professionals and skills from both the cure and care sectors to meet those needs. In other words, on the one hand people needs are changing and growing challenging the financial sustainability of health care systems while on the other delivery services are still linked to traditional organizational models and resources – people, time, facilities and knowledge— are scarce. In this contest Integrated care (IC) arrangements have emerged in a variety of ways and have become a priority in the policy agenda at National and Regional level throughout Europe. In response to concerns that the needs of the aging population for well-integrated care are increasing, our research aims to evaluate the impact of IC programs in terms of improvements in the quality of life, patient satisfaction, staff satisfaction and change in work processes. According to the literature evidence stating that the effectiveness of attempts to provide better integrated care is highly dependent on the context in which the intervention takes place and cannot be seen separated from this, the question guiding our research shifts from “what is the effectiveness of the particular integrated model (compared with non-integrated)?” to “what is the effectiveness of integrated model designed for a specific context?.”