Abstract：
Vertical integration of health and social care organizations is widely regarded as an effective way to deliver improved outcomes for recipients of the services provided by those organizations. We test this hypothesis by investigating the impact of the creation of integration authorities in Scotland - statutory bodies responsible for planning and resourcing adult social care, primary care, community health and unscheduled hospital care at the local level. Employing a difference-in-difference style analysis we compare delayed discharges and premature mortality rates in Scottish integration authorities with those for local authority areas in the North of England for the period 2013-2019. The results suggest that health and social care integration led to improved performance on delayed discharges in Scotland (point estimate, -0.236; 95% confidence interval, -0.443, -0.029), but that premature mortality rates remained unchanged. These findings suggest that the vertical integration of local health and social care organizations may enhance organizational efficiency and patient experience, but that improvements on broader indicators of population health are more difficult to achieve.
摘要：
卫生和社会护理组织的垂直整合被广泛认为是为这些组织提供的服务的接受者提供更好成果的有效途径。我们通过调查苏格兰建立一体化机构的影响来检验这一假设-负责计划和为成人社会护理提供资源的法定机构，初级保健,地方一级的社区卫生和计划外医院护理。采用差异式差异分析，我们比较了2013-2019年期间苏格兰一体化当局与英格兰北部地方当局地区的延迟出院率和过早死亡率。结果表明，健康和社会护理一体化导致苏格兰延迟出院的表现有所改善(点估计，-0.236；95%置信区间，-0.443,-0.029),但是过早死亡率保持不变。这些发现表明，地方卫生和社会护理组织的垂直整合可能会提高组织效率和患者体验，但是更广泛的人口健康指标的改善更难实现。
