Defining the integrated neighbourhood model: a systematic review of key domains and framework development

Abstract

Background: Health systems are increasingly adopting Integrated Neighbourhoods (INs) to deliver hyper-local, community-based care that integrates health, social care, and public sector resources to address healthcare costs, improve outcomes, and reduce health inequalities. However, IN models lack a unified definition and standard framework for development and evaluation, limiting their scalability and effectiveness. This systematic review aims to establish a foundational framework for INs, identifying key domains to guide their implementation (including barriers of implementation, evaluation, and potential for future research. Methods: A systematic literature search, restricted to the English language, was performed to identify relevant studies with expert librarian support. Study quality was assessed with the Mixed-Methods Appraisal Tool (MMAT). A Braun and Clarke thematic analysis was conducted to identify recurring themes and extract key domains. Results: A total of 29 studies met the inclusion criteria, encompassing a diverse range of IN models with varying focus areas and methodologies. Seven key domains emerged as central to effective IN models: integrator host, integrator enablers, integrator partnership principles, core integrated workforce, core areas of work, and services provided. These domains support multidisciplinary collaboration, enhance resource utilisation, and promote community engagement. However, barriers such as funding limitations, digital exclusion, and inconsistent evaluation frameworks present challenges to IN scalability and sustainability. Conclusion: This proposed framework provides a starting point for a standardised structure for implementing and evaluating INs, guiding clinicians, academics, and policymakers in developing sustainable, equitable, and adaptable community-based care solutions with the potential to improve access to patients from low-socioeconomic and underserved communities. Trial Registration: PROSPERO ID: CRD42024597197; available: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=597197.