Integrated care in the unified health system of Brazil: The laboratory for innovation in chronic conditions in Santo Antônio do Monte

ABSTRACTThe growing burden of chronic diseases is challenging health systems as well as economic and social development in many countries. Integration of care delivery is one of the key strategies to tackle these issues. Transitioning towards integrated care requires the capacity of managing change. This article explores the experience of the Laboratory for Innovations in Chronic Conditions in the municipality of Santo Antonio do Monte (Brazil), as a promoter and facilitator of the shift towards an integrated chronic care model. The purpose of this paper is to describe, analyse and extract relevant lessons from this experience concerning the role of a change agent to (1) overcome the challenges of diffusion of integrated care innovations at scale and pace and to (2) promote learning for implementation of integrated care delivery. Following a detailed description of the experience in itself, covering its background, context, core elements at the different levels of care and financing model, the main prelim...