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Abbasi Moghaddam M A, Razavi S M, Nooraei S M,
Volume 62, Issue 1 (4-2004)
Abstract

Background: The idea of integration of medical education into health care system with the goal of comprehensive self sufficiency and complete response to public health needs were initiated in 1985. There were many prose and cones in this procedure which raised many controversies. The dilemma about strengths and weaknesses increased in 2002 during which Iran parliament tried to change the situation. In this study we tried to conclude and exit the dilemma.

Materials and Methods: We studied the attitude of key academic person regarding the integration. In a cross-sectional study using a pretested questionnaire, we assessed the attitude of 556 academic staffs and managers from eight randomly selected medical universities.

Results: Most of respondents agreed the positive out come of integration like establishment of disease surveillance and improving in health indicators, but they believed that the quality of medical education has decreased. Most of respondents suppose that dissociation of medical education may cause a lot of problems.

Conclusion: There are a lot of controversies regarding the strengths and weaknesses of integration. External factors were causes of decreasing the quality of education so it is important to decide about the future by considering external factors.


Aida Asghari, Abbas Vosoogh Moghaddam , Ali Mohammad Mosadeghrad , Ebrahim Jaafaripooyan,
Volume 82, Issue 2 (5-2024)
Abstract

Background: Communication and cooperation among health care organizations have become nowadays crucial for improving the quality and equity in providing health services, and integration has been expressed as a solution by the World Health Organization. The purpose of this review was to identify the challenges and solutions of integration in health services.
Methods: This research was carried out from September 2023 to April 2024. All articles on the challenges and solutions of integration in health, using scoping review, were identified and used in the PubMed, Scopus, Web of Science and Google Scholar search engines in the period from 2000 to 2024. The total number of English articles found was 4996, of which 662 were removed due to repetition. Among the remaining 4334 articles, 4249 articles whose titles and abstracts were not related to the research topic were removed, left a total of 85 articles, and after reviewing the full text of the articles, 27 articles entered the data extraction phase, which were finally analyzed using the framework analysis method.
Results: Finally, 27 articles were selected from which, 46 challenges and 26 solutions were extracted as to the integration in health services and categorized based on the framework of WHO six building blocks in five areas of governance and leadership, financing, human resources, information system and service delivery. The most important challenges of integration include; weakness in planning, imbalance of power between organizations, differences in geographical and spatial boundaries of organizations, weakness in maintaining data security, workforce resistance and the lack of laws and regulations, needs assessment from patients, related knowledge, financial resources, suitable payment models, integrated communication and information systems and interoperability between technologies. 
Conclusion: Integration of health service endures a series of challenges such mainly as the lack of rules and regulations for collaborative processes and resistance from providers and employees requiring innovative solutions. Addressing issues such as stakeholder power-benefit analysis, interoperability and data sharing among the providers could be essential for successful integration.


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