A conceptual model for physician-system integration: A scoping review

Abstract

Despite the widespread pursuit of physician-health system integration, the evidence for factors affecting successful integration is uncertain and inconclusive. We sought to identify and categorize the organizational factors in the current landscape of physician-health system integration. We conducted a scoping review of the empirical literature on this topic, first surveying the theoretical perspectives that have been used in past studies in order to determine how theory has been used to explain and predict changing integration strategies over time. Second, we extracted factors that have been used to define the environment, physician group, hospital, care coordination, and health system success. From the 29 eligible articles, bargaining-market power theory and transaction cost theory were the predominant theories applied. We identified 48 organizational factors that comprise the landscape of physician-system integration. Our findings cumulated in a conceptual model that may help health care executives, policymakers, and researchers more effectively address the complexities of integration.