What mechanisms lead to the endurance of health and social care integration? A multiple case study in Italy

Background The rising complexity of the population's needs has made health and social care integration a priority for the future. Despite the presence of supporting policies and funding, the number of successful experiences that endure over time is limited. Objective This work aims to investigate how health and social care integration occur and identify factors facilitating its endurance. Methods We conducted a multiple case study on four long-lasting health and social care integration cases in Italy, where a new policy for enhancing integration was introduced. 20 senior managers employed in the four cases were interviewed and 33 official documents and websites were collected. The interviews’ transcripts and documents were coded using an abductive approach. Results The modalities of health and social care integration can vary according to the level of integration, type of network governance, and level of customization. There is no one predominant solution as the modalities depend on the specific context. To support policy-makers and health and social care providers in designing and implementing a sustainable health and social care integration in their contexts, this study provides six possible macro factors that clarify the priorities for integration. Conclusions This paper clarifies the modalities of integration and provides macro factors for enduring health and social care integration over time, providing avenues for future supporting policies.