What's known about implementing co-located paediatric integrated care: a scoping review

Int Rev Psychiatry. 2018 Dec;30(6):242-271. doi: 10.1080/09540261.2018.1563530. Epub 2019 Mar 26.

Abstract

Several studies have demonstrated clinical benefits of integrated care for a range of child and adolescent mental health outcomes. However, there is a significant gap between the evidence for efficacy of integrated care interventions vs their implementation in practice. While several studies have examined large-scale implementation of co-located integrated care for adults, much less is known for children. The goal of this scoping review was to understand how co-located mental health interventions targeting children and adolescents have been implemented and sustained. The literature was systematically searched for interventions targeting child and adolescent mental health that involved a mental health specialist co-located in a primary care setting. Studies reporting on the following implementation outcomes were included: acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability. This search identified 34 unique studies, including randomized controlled trials, observational studies, and survey/mixed method approaches. Components facilitating implementation of on-site integrated behavioural healthcare included interprofessional communication and collaboration at all stages of implementation; clear protocols to facilitate intervention delivery; and co-employment of integrated care providers by specialty clinics. Some studies found differences in service use by demographic factors, and others reported funding challenges affecting sustainability, warranting further study.

Keywords: Integrated care; co-location; implementation; paediatric; primary care; utilization.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Child
  • Delivery of Health Care, Integrated / organization & administration*
  • Health Plan Implementation*
  • Humans
  • Outcome Assessment, Health Care*
  • Pediatrics*
  • Pilot Projects
  • Primary Health Care / organization & administration*
  • Referral and Consultation