ArticleSociology of health & illness2022
Why doesn't integrated care work? Using Strong Structuration Theory to explain the limitations of an English case.
Article in Sociology of health & illness, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 46 citations in OpenAlex.
- Integrating Self-Management Education and Support in Routine Care of People With Type 2 Diabetes Mellitus: A Conceptional Model Based on Critical Interpretive Synthesis and A Consensus-Building Participatory Consultation.Frontiers in clinical diabetes and healthcare · 2022Pooled it
- Trial
- Understanding safe sport as a public health practice: a strong structuration theory analysis of Swedish elite athletics sport personnel.BMC public health · 2026Article
- The FAIR Case for A Coherent Interoperability to support NHS 10 Year Health Plan.Scientific data · 2026Article
- Palliative care perceptions and well-being in nurses across healthcare settings: a comparative study from Reggio Emilia, Northern Italy.BMC palliative care · 2025Article
- Integrated care in practice: lessons from three tiers of healthcare provider and commissioner staff in two London Integrated Care Systems.BJPsych open · 2025Article
- Reconfiguring Pain Interpretation Within a Social Model of Health Using a Simplified Version of Wilber's All Quadrant All Levels Framework: An Integral Vision.Behavioral sciences (Basel, Switzerland) · 2025Article
- An integral vision of pain and its persistence: a whole-person, whole-system, salutogenic perspective.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Older adults experience of transition to the community from the emergency department: a qualitative evidence synthesis.BMC geriatrics · 2024Article
- How Person-Centred Is Cardiac Rehabilitation in England? Using Bourdieu to Explore Socio-Cultural Influences and Personalisation.Qualitative health research · 2024Article
- The development of an integrated neighborhood approach for health promotion and prevention: a qualitative exploration of stakeholders' views.Health research policy and systems · 2023Article
- Primary care services in the English NHS: are they a thorn in the side of integrated care systems? A qualitative analysis.BMC primary care · 2023Article
- Perceptions of the primary health care team about the implementation of integrated care of patients with type 2 diabetes and hypertension in Slovenia: qualitative study.BMC health services research · 2023Article
- Implementing a community specialist team to support the delivery of integrated diabetes care: experiences in Ireland during the COVID-19 pandemic.HRB open research · 2023Article
- Strong structuration analysis of patterns of adherence to hypertension medication.SSM. Qualitative research in health · 2022Article
- Why doesn't integrated care work? Using Strong Structuration Theory to explain the limitations of an English case.Sociology of health & illness · 2022Article
- Assessing Healthcare Integration: An Integrated Palliative Care System in Spain.International journal of integrated careArticle
- Integrated System Responses for Families Impacted by Violence: A Scoping Review.International journal of integrated careArticle
- Inter-Disciplinary Work in the Context of Integrated Care - a Theoretical and Methodological Framework.International journal of integrated careArticle
- How Do Older People Experience Person-Centred Integrated Care? An Integrative Review of the Evidence.International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
Integrated care is an aim and a method for organising health and care services, particularly for older people and those with chronic conditions. Policy expects that integrated care programmes will provide person-centred coordinated care which will improve patient or client experience, enable population health, prevent hospital admissions and thereby reduce costs. However, empirical evaluations of integrated care interventions have shown disappointing results. We analysed an in-depth case study using Strong Structuration Theory to ask: how and why have efforts to integrate health and social care failed to produce desired outcomes? In our case, integrated case management and the creation of cost-saving plans were dominant practices. People working in health and social care recursively produced a structure of integrated care: a recognised set of resources created by collective activities. Integrated care, intended to help patients manage their long-term conditions and avoid hospital admission, was only a small part of the complex network that sustained patients at home. The structures of integrated care were unable to compensate for changes in patients' health. The result was that patients' experiences remained largely unaffected and hospital admissions were not easily avoided.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.