Opening the black box of integrated care; an exploratory study of a large scale integrated care program in the Netherlands

Background: Designed to enhance the integration of services in a primary care (outpatient) setting, the Primary focus program funds 70 integrated care projects (ICP). Main objective of this study was to determine the patterns of integrated care among the ICP. An evaluation framework was developed to assess the focus (person vs. population), level (clinical, professional, organisational and system) and enablers (functional vs. normative) of integrated care among the ICP. Methods: A multiple embedded case-study design drawing on multiple data sources (both qualitative and quantitative) was used to determine the different archetypes of integrated care among the ICP. Patterns were formed based on the focus (person vs. population), level (clinical, professional, organisational and system) and enablers (functional vs. normative), using cluster analysis. Results en conclusion: Preliminary results suggest that the evaluation framework is useful for assessing the different building blocks of integrated care. Distinguishing unique clusters found among the ICP of the Primary focus program will be presented and discussed.