A scoping review on community health care centers: Evidence in support of Italian policymakers to redesign the Italian primary care system

Background: The COVID-19 pandemic underscored the central role of primary health care in managing patients with complex and chronic health conditions. In response, the Italian government launched a reform of the National Health Service, introducing Community Health Care Centers (“Case della Comunità”) as a key pillar of the new primary care model. Evidence is needed on which organizational features of such centers best support integrated, high-quality care. Objective: This scoping review synthesized international evidence on community health care centers characterized by integrated care and co-location of professionals, to identify organizational elements relevant to the Italian reform. Methods: We conducted a scoping review of international literature on community health care centers. Included studies were assessed using eight integration domains derived from Valentijn’s taxonomy, which were combined into an overall integration score. Additional features, including horizontal collaboration, accessibility, home care, and multiprofessional integration, were also analyzed. Results: Statistical analysis showed a positive association between horizontal collaboration, overall level of integration, and multiprofessional integration. Centers with higher integration and stronger horizontal collaboration more often reported improved organization of services and care for people with complex or chronic conditions. Conclusions: These findings support Community Health Care Centers in Italy as integrated, multiprofessional hubs within the primary care network, where strengthened horizontal collaboration may improve quality and continuity of care for complex and chronic patients.