{"id":"https://openalex.org/W7223687203","doi":"https://doi.org/10.1093/eurpub/ckag169.781","title":"What does productivity mean in integrated care? A scoping review on concepts, measures, and gaps","display_name":"What does productivity mean in integrated care? A scoping review on concepts, measures, and gaps","publication_year":2026,"publication_date":"2026-10-01","ids":{"openalex":"https://openalex.org/W7223687203","doi":"https://doi.org/10.1093/eurpub/ckag169.781"},"language":"en","primary_location":{"id":"doi:10.1093/eurpub/ckag169.781","doi":"https://doi.org/10.1093/eurpub/ckag169.781","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.781","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.781/72464857/ckag169.781.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.781/72464857/ckag169.781.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5159583775","display_name":"JP Koivisto","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I39624965","display_name":"Finnish Institute for Health and Welfare","ror":"https://ror.org/03tf0c761","country_code":"FI","type":"funder","lineage":["https://openalex.org/I39624965"]}],"countries":["FI"],"is_corresponding":false,"raw_author_name":"JP Koivisto","raw_affiliation_strings":["Finnish Institute for Health and Welfare , Helsinki,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Finnish Institute for Health and Welfare , Helsinki,","institution_ids":["https://openalex.org/I39624965"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5021754886","display_name":"Eeva Liukko","orcid":"https://orcid.org/0009-0003-8937-3240","observed_orcids":["https://orcid.org/0009-0003-8937-3240"]},"institutions":[{"id":"https://openalex.org/I39624965","display_name":"Finnish Institute for Health and Welfare","ror":"https://ror.org/03tf0c761","country_code":"FI","type":"funder","lineage":["https://openalex.org/I39624965"]}],"countries":["FI"],"is_corresponding":false,"raw_author_name":"E Liukko","raw_affiliation_strings":["Finnish Institute for Health and Welfare , Helsinki,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Finnish Institute for Health and Welfare , Helsinki,","institution_ids":["https://openalex.org/I39624965"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159586181","display_name":"S Majlander","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I39624965","display_name":"Finnish Institute for Health and Welfare","ror":"https://ror.org/03tf0c761","country_code":"FI","type":"funder","lineage":["https://openalex.org/I39624965"]}],"countries":["FI"],"is_corresponding":true,"raw_author_name":"S Majlander","raw_affiliation_strings":["Finnish Institute for Health and Welfare , Helsinki,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Finnish Institute for Health and Welfare , Helsinki,","institution_ids":["https://openalex.org/I39624965"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159718067","display_name":"S Launio","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I39624965","display_name":"Finnish Institute for Health and Welfare","ror":"https://ror.org/03tf0c761","country_code":"FI","type":"funder","lineage":["https://openalex.org/I39624965"]}],"countries":["FI"],"is_corresponding":false,"raw_author_name":"S Launio","raw_affiliation_strings":["Finnish Institute for Health and Welfare , Helsinki,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Finnish Institute for Health and Welfare , Helsinki,","institution_ids":["https://openalex.org/I39624965"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5159692515","display_name":"K Pasanen","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I39624965","display_name":"Finnish Institute for Health and Welfare","ror":"https://ror.org/03tf0c761","country_code":"FI","type":"funder","lineage":["https://openalex.org/I39624965"]}],"countries":["FI"],"is_corresponding":false,"raw_author_name":"K Pasanen","raw_affiliation_strings":["Finnish Institute for Health and Welfare , Helsinki,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Finnish Institute for Health and Welfare , Helsinki,","institution_ids":["https://openalex.org/I39624965"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5159586181"],"corresponding_institution_ids":["https://openalex.org/I39624965"],"apc_list":{"value":2815,"currency":"EUR","value_usd":3181},"apc_paid":{"value":2815,"currency":"EUR","value_usd":3181},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.84109525,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"36","issue":"Supplement_5","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.2581000030040741,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T12871","display_name":"Healthcare Quality and Management","score":0.2581000030040741,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13896","display_name":"Health Services Management and Policy","score":0.19120000302791595,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10391","display_name":"Healthcare Policy and Management","score":0.11089999973773956,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/integrated-care","display_name":"integrated care","score":0.996999979019165},{"id":"https://openalex.org/keywords/productivity","display_name":"productivity","score":0.8309999704360962},{"id":"https://openalex.org/keywords/cost-effectiveness","display_name":"cost-effectiveness","score":0.703000009059906},{"id":"https://openalex.org/keywords/resource-utilization-health-care","display_name":"resource utilization (health care)","score":0.7160000205039978},{"id":"https://openalex.org/keywords/job-performance","display_name":"employee performance","score":0.7250000238418579},{"id":"https://openalex.org/keywords/value-for-money","display_name":"value for money","score":0.5019999742507935},{"id":"https://openalex.org/keywords/handover","display_name":"handover","score":0.49000000953674316},{"id":"https://openalex.org/keywords/long-term-evaluation","display_name":"long-term evaluation","score":0.7049999833106995},{"id":"https://openalex.org/keywords/efficiency-indicators","display_name":"efficiency indicators","score":0.5350000262260437}],"concepts":[{"id":"https://openalex.org/C2779541514","wikidata":"https://www.wikidata.org/wiki/Q1477478","display_name":"Integrated care","level":3,"score":0.6837000250816345},{"id":"https://openalex.org/C204983608","wikidata":"https://www.wikidata.org/wiki/Q2111958","display_name":"Productivity","level":2,"score":0.6782000064849854},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5199000239372253},{"id":"https://openalex.org/C2778139618","wikidata":"https://www.wikidata.org/wiki/Q13440398","display_name":"Workforce","level":2,"score":0.5170000195503235},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.4546000063419342},{"id":"https://openalex.org/C74196892","wikidata":"https://www.wikidata.org/wiki/Q7781188","display_name":"Thematic analysis","level":3,"score":0.4480000138282776},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.44200000166893005},{"id":"https://openalex.org/C56739046","wikidata":"https://www.wikidata.org/wiki/Q192060","display_name":"Knowledge management","level":1,"score":0.4120999872684479},{"id":"https://openalex.org/C100001284","wikidata":"https://www.wikidata.org/wiki/Q2248246","display_name":"Public economics","level":1,"score":0.3720000088214874},{"id":"https://openalex.org/C72634772","wikidata":"https://www.wikidata.org/wiki/Q386824","display_name":"Data integration","level":2,"score":0.3463999927043915},{"id":"https://openalex.org/C195094911","wikidata":"https://www.wikidata.org/wiki/Q14167904","display_name":"Process management","level":1,"score":0.32280001044273376},{"id":"https://openalex.org/C134560507","wikidata":"https://www.wikidata.org/wiki/Q753291","display_name":"Environmental economics","level":1,"score":0.30709999799728394},{"id":"https://openalex.org/C206345919","wikidata":"https://www.wikidata.org/wiki/Q20380951","display_name":"Resource (disambiguation)","level":2,"score":0.30070000886917114},{"id":"https://openalex.org/C2777466982","wikidata":"https://www.wikidata.org/wiki/Q5227287","display_name":"Data extraction","level":3,"score":0.2948000133037567},{"id":"https://openalex.org/C93692415","wikidata":"https://www.wikidata.org/wiki/Q1502030","display_name":"Thematic map","level":2,"score":0.28790000081062317},{"id":"https://openalex.org/C2780513914","wikidata":"https://www.wikidata.org/wiki/Q18210350","display_name":"Bottleneck","level":2,"score":0.28780001401901245},{"id":"https://openalex.org/C2780233487","wikidata":"https://www.wikidata.org/wiki/Q6672123","display_name":"Long-term care","level":2,"score":0.28769999742507935},{"id":"https://openalex.org/C199033989","wikidata":"https://www.wikidata.org/wiki/Q1318295","display_name":"Narrative","level":2,"score":0.2865000069141388},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.28519999980926514},{"id":"https://openalex.org/C2777958785","wikidata":"https://www.wikidata.org/wiki/Q17120940","display_name":"Resource efficiency","level":2,"score":0.2759999930858612},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.2750000059604645},{"id":"https://openalex.org/C21547014","wikidata":"https://www.wikidata.org/wiki/Q1423657","display_name":"Operations management","level":1,"score":0.2655999958515167},{"id":"https://openalex.org/C19527686","wikidata":"https://www.wikidata.org/wiki/Q1665453","display_name":"System integration","level":2,"score":0.2619999945163727},{"id":"https://openalex.org/C14224292","wikidata":"https://www.wikidata.org/wiki/Q13600188","display_name":"Conceptual framework","level":2,"score":0.2590999901294708},{"id":"https://openalex.org/C2994130222","wikidata":"https://www.wikidata.org/wiki/Q205398","display_name":"Social care","level":2,"score":0.2574999928474426},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.25690001249313354}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1093/eurpub/ckag169.781","doi":"https://doi.org/10.1093/eurpub/ckag169.781","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.781","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.781/72464857/ckag169.781.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13698553","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13698553/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13698553/pdf/ckag169.781.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Eur J Public Health","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/eurpub/ckag169.781","doi":"https://doi.org/10.1093/eurpub/ckag169.781","is_oa":true,"landing_page_url":"https://doi.org/10.1093/eurpub/ckag169.781","pdf_url":"https://academic.oup.com/eurpub/article-pdf/36/Supplement_5/ckag169.781/72464857/ckag169.781.pdf","source":{"id":"https://openalex.org/S4210220588","display_name":"European Journal of Public Health","issn_l":"1101-1262","issn":["1101-1262","1464-360X"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["abdc-b","anvur-class-a","anvur-scientific","cwts-core","doaj","dongbi-b","doyens","fnege-4","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"European Journal of Public Health","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":0.9074000120162964}],"study_designs":[{"display_name":"Systematic Review","id":"https://openalex.org/study-designs/systematic-review"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":false},"content_urls":{"pdf":"https://content.openalex.org/works/W7223687203.pdf"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2590618574","https://openalex.org/W6920980441","https://openalex.org/W4416799319","https://openalex.org/W4413385008","https://openalex.org/W2794730391","https://openalex.org/W96195444","https://openalex.org/W1589231766","https://openalex.org/W109334837","https://openalex.org/W2125357524","https://openalex.org/W7135233073"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Integrated":[2,158],"care":[3,14,49,75,159,185,241,252],"is":[4,20,117,131,186],"widely":[5],"promoted":[6],"to":[7,84,111],"address":[8],"fragmentation":[9],"in":[10,76,137,142,183,250],"health":[11,72],"and":[12,31,34,63,73,80,98,106,127,151,206,217,220,255],"social":[13,74],"systems.":[15],"A":[16,52],"central":[17],"policy":[18],"assumption":[19],"that":[21],"integration":[22,83,175],"will":[23],"improve":[24],"productivity.":[25],"However,":[26],"evidence":[27],"remains":[28],"conceptually":[29],"contested":[30],"methodologically":[32],"heterogeneous,":[33],"no":[35,171],"consolidated":[36],"overview":[37],"exists":[38],"of":[39,196,239],"how":[40],"productivity":[41,225,238,249],"has":[42],"been":[43],"defined":[44],"or":[45,87],"measured":[46],"across":[47],"integrated":[48,71,184,240,251],"research.":[50],"Methods":[51],"scoping":[53],"review":[54],"was":[55,176],"conducted":[56],"following":[57],"established":[58],"methodological":[59],"guidance.":[60],"Peer-reviewed":[61],"studies":[62,169],"reviews":[64],"(2010\u20132025)":[65],"were":[66,109],"included":[67,113],"if":[68],"they":[69],"examined":[70],"a":[77,187],"European":[78],"context":[79],"explicitly":[81],"linked":[82],"productivity,":[85],"efficiency,":[86,123],"resource":[88,149],"use.":[89],"Six":[90],"databases":[91],"yielded":[92],"2,027.":[93],"AI":[94],"tools":[95],"supported":[96],"screening":[97],"data":[99],"extraction":[100],"with":[101,135],"full":[102],"researcher":[103],"validation.":[104],"Narrative":[105],"thematic":[107],"synthesis":[108],"applied":[110],"30":[112],"studies.":[114],"Results":[115],"Productivity":[116,182],"operationalised":[118],"through":[119],"multiple":[120],"dimensions:":[121],"utilisation":[122],"cost-effectiveness,":[124],"workforce":[125],"performance,":[126],"system-level":[128],"value.":[129],"Integration":[130],"most":[132],"consistently":[133],"associated":[134],"reductions":[136],"unplanned,":[138],"high-cost":[139],"service":[140],"use":[141],"high-need":[143],"populations.":[144],"Gains":[145],"more":[146],"often":[147],"reflect":[148],"substitution":[150],"avoided":[152],"escalation":[153],"than":[154,179],"net":[155],"cost":[156],"savings.":[157],"can":[160],"be":[161],"cost-effective":[162],"even":[163],"when":[164],"short-term":[165,230],"costs":[166],"rise.":[167],"Several":[168],"report":[170],"effects,":[172],"particularly":[173],"where":[174],"structural":[177],"rather":[178],"operational.":[180],"Conclusions":[181],"multidimensional,":[188],"relational":[189],"construct.":[190],"Conventional":[191],"indicators":[192],"capture":[193],"only":[194],"part":[195],"its":[197],"value,":[198],"rendering":[199],"invisible":[200],"gains":[201],"such":[202],"as":[203,223],"smoother":[204],"handovers":[205],"reduced":[207],"client":[208],"coordination":[209],"burden.":[210],"Evaluations":[211],"should":[212,228],"adopt":[213],"longer":[214],"time":[215],"horizons":[216],"treat":[218],"friction":[219],"navigation":[221],"burden":[222],"legitimate":[224],"indicators.":[226],"Policy":[227],"resist":[229],"efficiency":[231],"metrics":[232],"alone.":[233],"Key":[234],"messages":[235],"\u2022":[236,247],"The":[237],"emerges":[242],"from":[243],"connections,":[244],"not":[245],"structures.":[246],"Measuring":[248],"requires":[253],"multidimensional":[254],"long-term":[256],"evaluation":[257],"frameworks.":[258]},"counts_by_year":[],"updated_date":"2026-11-03T10:50:19.383937","created_date":"2026-10-27T00:00:00"}
