Affordability and Sustainability in Integrated Care

In the last two decades healthcare spending has been raised steadily in most OECD countries for different reasons, such as the ageing of population, the rising prevalence of chronic diseases and co-morbidities as well as the increasing costs of hospital services. Sustainability of health systems is therefore becoming a very pressing issue, especially if we consider that due to the global economic crisis governments are starting to cut health and social budgets seriously. Moreover, the need to assure financial sustainability of health systems without undermining the value of universal coverage, solidarity in financing, equity of access and provision of high-quality health care - as stressed by the Council of European Union in "Statement on Common Values and Principles" - makes this issue even more challenging. Interventions aiming to integrate care service provision are beginning to be considered as a changing paradigm to improve the quality of services and, at the same time, promoting its sustainability. Evaluation of these interventions both in terms of costs and benefits may consider different aspects and perspectives and apply different types of measurements. Considering the different definitions of integrated care, this contribution will provide an overview of some of the main issues pertaining requisites, methods and indicators to evaluate the economic and financial effects on the provision of integrated care.