Health promotion and disease prevention in integrated delivery systems: the role of market forces.

This article proposes a framework for the study of the effects of market forces on health promotion and disease prevention (HP/ DP) in integrated delivery systems (IDSs). We describe the evolution of IDSs in the United States and review the limited research on the extent to which IDSs have integrated HP/DP. We propose a typology of HP/DP activities that provides a comprehensive model of the types of HP/DP services and functions that an IDSs may incorporate. Finally, we identify and discuss the major market stages through which IDSs are transitioning, and within each market stage we identify the major forces that may influence IDS decisions to incorporate HP/DP services.