Research Review: Integrated healthcare for children and young people in secondary/tertiary care – a systematic review

Naomi Pygott, Alex Hartley, Francesca Seregni, Tamsin J. Ford, Ian M. Goodyer, Andreea Necula, Arina Banu, Joanna K. Anderson

Research output: Contribution to journalReview articlepeer-review

3 Citations (SciVal)

Abstract

Background: Children and young people (CYP) with comorbid physical and/or mental health conditions often struggle to receive a timely diagnosis, access specialist mental health care, and more likely to report unmet healthcare needs. Integrated healthcare is an increasingly explored model to support timely access, quality of care and better outcomes for CYP with comorbid conditions. Yet, studies evaluating the effectiveness of integrated care for paediatric populations are scarce. Aim and Methods: This systematic review synthesises and evaluates the evidence for effectiveness and cost-effectiveness of integrated care for CYP in secondary and tertiary healthcare settings. Studies were identified through systematic searches of electronic databases: Medline, Embase, PsychINFO, Child Development and Adolescent Studies, ERIC, ASSIA and British Education Index. Findings: A total of 77 papers describing 67 unique studies met inclusion criteria. The findings suggest that integrated care models, particularly system of care and care coordination, improve access and user experience of care. The results on improving clinical outcomes and acute resource utilisation are mixed, largely due to the heterogeneity of studied interventions and outcome measures used. No definitive conclusion can be drawn on cost-effectiveness since studies focused mainly on costs of service delivery. The majority of studies were rated as weak by the quality appraisal tool used. Conclusions: The evidence of on clinical effectiveness of integrated healthcare models for paediatric populations is limited and of moderate quality. Available evidence is tentatively encouraging, particularly in regard to access and user experience of care. Given the lack of specificity by medical groups, however, the precise model of integration should be undertaken on a best-practice basis taking the specific parameters and contexts of the health and care environment into account. Agreed practical definitions of integrated care and associated key terms, and cost-effectiveness evaluations are a priority for future research.

Original languageEnglish
Pages (from-to)1264-1279
Number of pages16
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Volume64
Issue number9
Early online date1 Aug 2023
DOIs
Publication statusPublished - 30 Sept 2023
Externally publishedYes

Keywords

  • care coordination
  • Children and young people
  • integrated care
  • mental health
  • secondary and tertiary care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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