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Many hold that performance in health care can be improved. However, the state-of-the-art on health care improvement indicates that improvement activities and strategies have too limited success so far. From a ‘systems perspective’, this limited success stems from a lack of coherence among the various strategies and instruments employed. For example, practice guidelines, client councils, regulated competition, and disease management differ in purpose and approach. Therefore, it can be argued that all improvement activities should be embedded more synergistically in health care. ‘Community-based integrated care’ is a strategic vision on how this synergy could be realized. It promotes more joined and consistent action (‘‘integrated’’) towards a better performing health care system that maximises population health (‘‘community-based’’).

Building a Tower of Babel in health care? Theory & practice of community-based integrated care