What does this research mean for the field?

Fragmented macro-governance structures and responsibilities frequently undermine regulatory alignment and constrain system-level coherence in integrated primary care, requiring more coherent policy mixtures to succeed. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

Synthesize empirical evidence on macro-level governance arrangements and policy design strategies that support system-level integration in primary care.

August 22, 2026Discover Health SystemsOpen Access

A systematized narrative review of macro governance and policy design supporting integrated primary care

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Authors

MDMariève Dupont CHCatherine Hudon EMElisabeth Martin

Discussion

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Overview

Systematized narrative review demonstrates that fragmented governance undermines policy alignment in integrated primary care, highlighting the need for coherent systemic reform strategies.

Key Points

Synthesize empirical evidence on macro-level governance arrangements and policy design strategies that support system-level integration in primary care.
Conducted a systematized narrative review searching Medline, CINAHL, ABI/Inform, Health & Medical Collection, and International Political Science Abstracts through March 2025.
Identified peer-reviewed empirical studies published between 2010 and 2025 focusing on macro-level policies or national strategies for integrated primary care.
Analyzed 34 included studies using the Rainbow Model of Integrated Care (RMIC) alongside Knoepfel’s policy analysis framework.
Integrated primary care policies utilize mixtures of organizational, regulatory, financial, and informational instruments spanning top-down, bottom-up, and participatory formulation strategies.
Fragmented macro-governance structures and external socioeconomic pressures frequently disrupt regulatory alignment and limit system-level coherence.
Identified persistent knowledge gaps regarding optimal political arrangements and causal mechanisms driving sustainable systemic integration.

Cite This Study

Dupont et al. (2026) studied this question.

synapsesocial.com/papers/6a895eaeca7ade938187cd10 https://doi.org/10.1007/s44250-026-00413-z

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August 22, 2026Discover Health SystemsOpen Access

A systematized narrative review of macro governance and policy design supporting integrated primary care

View Full Paper

Ask AI

Bookmark

Authors

MDMariève Dupont CHCatherine Hudon EMElisabeth Martin

Discussion

Member takes

Overview

Systematized narrative review demonstrates that fragmented governance undermines policy alignment in integrated primary care, highlighting the need for coherent systemic reform strategies.

Key Points

Synthesize empirical evidence on macro-level governance arrangements and policy design strategies that support system-level integration in primary care.
Conducted a systematized narrative review searching Medline, CINAHL, ABI/Inform, Health & Medical Collection, and International Political Science Abstracts through March 2025.
Identified peer-reviewed empirical studies published between 2010 and 2025 focusing on macro-level policies or national strategies for integrated primary care.
Analyzed 34 included studies using the Rainbow Model of Integrated Care (RMIC) alongside Knoepfel’s policy analysis framework.
Integrated primary care policies utilize mixtures of organizational, regulatory, financial, and informational instruments spanning top-down, bottom-up, and participatory formulation strategies.
Fragmented macro-governance structures and external socioeconomic pressures frequently disrupt regulatory alignment and limit system-level coherence.
Identified persistent knowledge gaps regarding optimal political arrangements and causal mechanisms driving sustainable systemic integration.

Cite This Study

Dupont et al. (2026) studied this question.

synapsesocial.com/papers/6a895eaeca7ade938187cd10 https://doi.org/10.1007/s44250-026-00413-z

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