Work

What does productivity mean in integrated care? A scoping review on concepts, measures, and gaps

Year: 2026

Type: article

Abstract: Background Integrated care is widely promoted to address fragmentation in health and social care systems. A central policy assumption is that integration will improve productivity. However, evidence remains conceptually contested and methodologically heterogeneous, and no consolidated overview exists of how productivity has been defined or measured across integrated care research. Methods A scoping review was conducted following established methodological guidance. Peer-reviewed studies and reviews (2010–2025) were included if they examined integrated health and social care in a European context and explicitly linked integration to productivity, efficiency, or resource use. Six databases yielded 2,027. AI tools supported screening and data extraction with full researcher validation. Narrative and thematic synthesis were applied to 30 included studies. Results Productivity is operationalised through multiple dimensions: utilisation efficiency, cost-effectiveness, workforce performance, and system-level value. Integration is most consistently associated with reductions in unplanned, high-cost service use in high-need populations. Gains more often reflect resource substitution and avoided escalation than net cost savings. Integrated care can be cost-effective even when short-term costs rise. Several studies report no effects, particularly where integration was structural rather than operational. Conclusions Productivity in integrated care is a multidimensional, relational construct. Conventional indicators capture only part of its value, rendering invisible gains such as smoother handovers and reduced client coordination burden. Evaluations should adopt longer time horizons and treat friction and navigation burden as legitimate productivity indicators. Policy should resist short-term efficiency metrics alone. Key messages • The productivity of integrated care emerges from connections, not structures. • Measuring productivity in integrated care requires multidimensional and long-term evaluation frameworks.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckag169.781

Authors: JP Koivisto, E Liukko, S Majlander, S Launio, K Pasanen

Institution: Finnish Institute for Health and Welfare

Language: English

Topic: Healthcare Quality and Management

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,181