In order to organize person-centered health services for a growing number of people with multiple complex health and social care needs, a shift from fragmented to integrated health services delivery has to take place. For the organization of governance in integrated health services, it is important to better understand the underlying factors that drive collaboration, decision-making and behavior between individuals and organizations. Therefore, this article focuses on these underlying normative aspects of integrated health services. This study investigates the values that underpin integrated health services delivery as a concept, by examining the extent to which an initial literature based set of underlying values underpins integrated care and the relevance of these values on the different levels of integration. An international Delphi study with 33 experts from 13 different countries was carried out to examine the initial set of underlying values of integrated health services. In addition, the relevance of the values was assessed on the different levels of integration: personal level, professional level, management level and system level. The study resulted in a refined set of 18 values of integrated health services developed in three Delphi study rounds. In addition, the results provided insight into the relevance of these values on the personal level (e.g. ‘trustful’), professional level (e.g. ‘collaborative’), management level (e.g. ‘efficient’) and system level (e.g. ‘comprehensive’) of integration. Some of the values score consistent across the different levels of integration while other values score inconsistent across these levels. The Delphi study resulted in an international normative basis for integrated health services delivery as a concept. The values can be used as ingredients for a values framework and provide a better understanding of the normative aspects of integrated health services delivery. Future research could focus on associated behaviors in practice, the relationship between normative integration and governance, and differences between the value priorities of stakeholder groups.

中文翻译：

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迈向综合卫生服务的价值框架：一项国际德尔菲研究

为了为越来越多具有多种复杂健康和社会护理需求的人组织以人为本的卫生服务，必须从分散的卫生服务提供转向综合的卫生服务提供。对于综合卫生服务的治理组织来说，更好地了解推动个人和组织之间协作、决策和行为的根本因素非常重要。因此，本文重点关注综合卫生服务的这些基本规范方面。本研究通过研究基于初始文献的一组基本价值观支撑综合护理的程度以及这些价值观在不同整合水平上的相关性，调查了支撑综合卫生服务提供这一概念的价值观。来自 13 个不同国家的 33 名专家参与了一项国际德尔菲研究，旨在检验综合卫生服务的初始基本价值。此外，在不同的整合层面上评估了价值观的相关性：个人层面、专业层面、管理层面和系统层面。该研究在三轮德尔福研究中形成了一套完善的综合卫生服务价值观，共 18 项。此外，结果还深入了解了这些价值观在个人层面（例如“信任”）、专业层面（例如“协作”）、管理层面（例如“高效”）和系统层面（例如“全面”）的相关性。的整合。一些值在不同集成级别上得分一致，而其他值在这些级别上得分不一致。德尔菲研究为综合卫生服务提供这一概念奠定了国际规范基础。这些价值观可以用作价值观框架的组成部分，并可以更好地理解综合卫生服务提供的规范方面。未来的研究可以关注实践中的相关行为、规范整合与治理之间的关系以及利益相关者群体价值优先级之间的差异。