Integrated care: the end of the hospital as we know it? Hospitals are often seen as an impediment to integrated care. The concern frequently voiced is that their dominant role in the health system makes it harder for commissioners to shift resources into the community and to develop more co-ordinated services that cross organisational boundaries.
It is certainly true that an over-reliance on hospital-based care, and the political reluctance to challenge this, has long been a barrier to necessary change in health systems across the world. Jean Rebert, one of the principal architects of the PRISMA integrated care system in Quebec, Canada, has made this case forcefully. Speaking at the World Congress on Integrated Care in Sydney last year, he said that in his experience the greatest obstacle to integrated care is the political attractiveness of prioritising investment in hospitals over other forms of care.
It is certainly true that an over-reliance on hospital-based care, and the political reluctance to challenge this, has long been a barrier to necessary change in health systems across the world. Jean Rebert, one of the principal architects of the PRISMA integrated care system in Quebec, Canada, has made this case forcefully. Speaking at the World Congress on Integrated Care in Sydney last year, he said that in his experience the greatest obstacle to integrated care is the political attractiveness of prioritising investment in hospitals over other forms of care.
