Normative assumptions in integrated care: A conceptual discussion

Abstract

There is no consensus to what integrated care is. Healthcare providers, patients, and family carers use the same term, integrated care, but the term may be ascribed different meanings. Integrated care often refers to situations where the coordination of healthcare is successful according to a given standard or norm. Integration is thus not a descriptive, but a prescriptive and normative concept. In this study, we claim that this normative aspect of integrated care represents a fundamental theoretical challenge, and that a shift towards how work and efforts are coordinated might be more fruitful. The goal of care work needs to be discussed in ways that allows relevant actors and stakeholders to participate and express their views and needs. When using the term integration, such important debates may be masked, as health officials, health managers, health professionals, patients, and family carers risk using the same word, integration, but attach diverging meanings to it.

Keywords:

• ALS/motor neurone disease
• Bureaucracy
• Integrated care
• Local knowledge
• Professions
• Subsystem

Additional information

Notes on contributors

Sverre V. Lerum

Sverre Vigeland Lerum is a medical sociologist. He is a PhD candidate at the Department of Health Management and Health economics at the University of Oslo. His researching on the organizing of care for people with the neurological condition amyotrophic lateral sclerosis.

Jan C. Frich

Jan C. Frich is a medical doctor and neurologist. He is an associate professor in healthcare management at the University of Oslo, and he is consultant at Centre for Rare Disorders, Oslo University Hospital.