Integrated care combines primary health care with hospital support through coordinated clinical, organizational, and policy changes. This approach reduces fragmentation and improves service efficiency, patient experience, and health outcomes.

A conceptual map organized into dimensions was developed to categorize the reviewed literature on integrated care policy instruments from a primary care perspective.

Evidence on the potential impact of integrated care on outputs and health outcomes was found to be scarce, and studies aiming to show the effect suffered from methodological limitations and were rarely generalisable. While integrated care models show promise when comprehensive, patient-centered, and bundled-payment schemes are used, the overall evidence on their effectiveness remains inconclusive due to contradictory findings and significant heterogeneity in how integrated care is measured and implemented.

Successful healthcare integration in Spain requires embedding interventions within systemic reforms, coordinated multi-level care, strong primary care leadership, patient empowerment, and political commitment to scale pilot programs into sustainable system-wide changes.

Successful implementation of integrated care faces significant knowledge and structural barriers – there are substantial research gaps regarding specific implementation tools, comparative regional analyses, and efficiency evaluations, while political will alone is insufficient without alignment of values among professionals and institutions, adequate resources, deep structural reforms, and coordination across multiple sectors to produce meaningful improvements.