The impact of healthcare funding on interprofessional collaboration and integrated service delivery in primary and allied healthcare: a scoping review

Abstract

This scoping review explores the concepts of integrated healthcare, interprofessional collaboration, and healthcare funding within the context of primary and allied healthcare. A systematic database, internet, and manual search of included article reference lists sought published and gray literature. From an initial 8,122 papers, a total of 63 met the inclusion criteria and were assessed using a three-stage narrative synthesis that sought to meaningfully account for the complexity and heterogeneity of the included papers: (1) Preliminary analysis involved data extraction and mapping of key themes, including article, integration, collaboration, and funding characteristics; (2) Robustness evaluation involved critically appraising the methodological quality of the literature using the Crowe Critical Appraisal Tool, and the Johns Hopkins Nursing Evidence-based Practice Research Evidence Appraisal Tool, and Non-Research Evidence Appraisal Tool; and (3) Relationship exploration found that most primary and allied healthcare services still operate under fee-for-service funding arrangements that discourage the delivery of integrated collaborative, coordinated, and complex care, instead encouraging traditional siloed and hierarchical approaches that are linked to workload, remuneration, and job satisfaction inequalities between primary and allied healthcare professions. Future research exploring sustainable blended funding models that encourage greater collaboration and integration among primary and allied healthcare is needed.