Introduction: This paper reports the development and validation of a questionnaire to assess collaboration between clinical professionals from two different care levels (primary and specialised care), according to the clinicians' own perceptions. This questionnaire has been elaborated to be used as part of the monitoring and evaluation process of the integrated care pilots in the public Basque Health Service.

IntroductionThis paper analyses the implementation of integrated care policies in the Basque Country through the deployment of an Integrated Health Organisation in Bidasoa area during the period 2011–2014. Structural, functional and clinical integration policies have been employed with the aim to deliver integrated and person-centred care for patients, especially for those living with chronic conditions.MethodsThis organisational case study used multiple data sources and methods in a pragmatic and reflexive manner to build a picture of the organisational development over a 4-year period. In order to measure the progress of integration three concepts have been measured: (i) readiness for chronicity measured with Assessment of Readiness for Chronicity in Healthcare Organisations tool; (ii) collaboration between clinicians from different care levels measured with the D'Amour Questionnaire, and (iii) overall impact of integration through several indicators based on the Triple Aim Framework.ResultsThe measurement of organisational readiness for chronicity showed improvements in five of the six areas under evaluation. Similarly the collaboration between professionals of different care levels showed a steady improvement in each of the 10 items. Furthermore, the Triple Aim-based indicators showed a better experience of care in terms of patients’ perceptions of care coordination; a reduction in hospital utilisation, particularly for patients with complex chronic conditions; and cost-containment in terms of per capita expenditure.ConclusionThere is a significant amount of data that shows that Bidasoa Integrated Health Organisation has progressed in terms of delivering integrated care for chronic conditions with a positive impact on several Triple Aim outcomes.

Introduction: This article explores the impact of the creation of a new integrated delivery organisation on the evolution of interprofessional collaboration between primary and secondary care levels. In particular, the case of the Bidasoa Integrated Healthcare Organisation is analysed.

ContextThe Basque Department of Health released in 2010 the “Strategy for tackling the challenge of chronicity in the Basque Country”. One of its five priority policies is contributing to the continuity of care for chronic patients. A key strategic project is the development of new integration initiatives and pilots projects in the public Basque Health System. Five different integration projects are already in place, with the Bidasoa Integrated Healthcare Organisation as the flagship project.AimThe creation of the Bidasoa Integrated Healthcare Organisation as a public brand new organisation in January 2011 aims at integrating three primary care centres and their regional hospital of reference, covering a total population of 86,235 citizens.Case descriptionThe Bidasoa integration process is characterised by its shared leadership, with converging top-down and bottom-up initiatives, and collaboration between top-management and clinicians. The initiatives for integration are operating simultaneously at different levels: strategic (integrated strategic plan), financial (common budget and capitation payment), managerial (integrated clinical management agreements), processes (integrated care pathways, development of transitional care nursing, creation of polipathology unit), tools (stratification of the population, unification of electronic health record), and research (development of action-research pilots).