What can be done to support integrated care?

Integrated care can be supported by investing in and applying the tools available for integrated care. There are many different ways in which professionals and providers can work directly with communities, patients/clients to support integrated care. These ‘tools’ of integrated care focus on the ‘how’ of clinical and service integration.

Different approaches have been used to integrate care, but they share this trait: they design all stages of care delivery around what is best for patients. The main strategy to improve access is to concentrate services in one location and providethem free-of-charge. An integrated service provision model minimizes the chances of stigmatization based on the fact that a client has come to receive certain services.

Effective linkage is based on an understanding of who is using drugs, which drugs are being used, what kinds of risk behaviours are related to drug use (e.g., sharing injection equipment and increased frequency of unprotected sex) and what steps need to be taken to reach out to and encourage PWUD to engage with HIV prevention activities and services.

There are clearly many issues going on “behind” this general definition and it is useful to look at “integration”- from various perspectives.

For the user, integration means health care that is seamless, smooth and easy to navigate. Users want a coordinated service which minimizes both the number of stages in an appointment and the number of separate visits to a health facility required. They want health workers to be aware of their health as a whole (not just one clinical aspect) and for health workers from different levels of a system to communicate well. In short, clients want continuity of care.

For providers, integration means that separate technical services (and their management support systems) are provided, managed, financed and evaluated either together, or in a closely coordinated way.

It is also important to understand factors related to HIV prevention, care, and treatment services, including: the kinds of services currently available; whether the services are user-friendly (i.e., appropriate, accessible, and acceptable and affordable to PWUD); and the policy and regulatory context within which drug use and HIV transmission occur and interventions will be implemented.