Association for Public Policy Analysis & Management

Integrated health and social care (IHSC) is the next frontier in engaging in a more holistic approach to addressing patient needs, especially high-risk populations. Extant literature demonstrates that IHSC can improve patient outcomes that enables a social determinants of health approach to care for vulnerable patient groups. This phenomenon is in its nascent stage in Canada, and continues to evolve and mature. The phenomenon within a Canadian context is not fully understood. A multiple case study of integrated health and social services initiatives (HIS) in Ontario, Alberta and Nova Scotia was undertaken to explore the factors that support successful services integration among different healthcare and social services organizations serving older adults. The three cases were voluntarily driven community-based IHSC initiatives: geriatric assessment program collaboratory in Camrose, AB; Healthy at Home in Toronto, ON and the Middleton Day Program, Annapolis Valley, NS. Based on key informant interviews and focus groups, it was discovered that there were common critical inter-organizational factors that support integration among all three cases, despite the variation in contextual factors. These included shared vision and goals, culture of collaboration and reliance, and communication. Despite differences in urban/rural geographic location and governing healthcare systems, the three cases shared two common external factors that helped to support integration: close sense of community, and supportive provincial and federal policies and agendas. The factors that support IHSC in the community highlight that technology and bureaucracy are not necessary to drive sustaining collaborative care for vulnerable patients/clients.