Financial Barriers Decrease Benefits of Interprofessional Collaboration within Integrated Care Programs: Results of a Nationwide Survey

Abstract

Introduction: Interprofessional collaboration (IPC) is a key ingredient of integrated care. Nevertheless, IPC benefits remain unclear and its implementation within integrated care initiatives is not straightforward. In this study, we first explored whether IPC was associated with organisational and patient care improvements in Swiss integrated care initiatives; we then investigated the effect of various barriers faced by these initiatives, on these associations. Methods: Self-reported data from 153 integrated care initiatives included in the Swiss Integrated Care Survey was used. We conducted moderated mediation analyses in which patient care improvements were the outcome, the degree of IPC implementation was the predictor, organisational improvements were the mediator, and professional, patient and financial barriers to integrated care, the moderators. Results: IPC implementation within integrated care was associated with organisational improvements, which in turn were associated with patient care improvements; this path no longer existed when financial barriers to integrated care were considered. Conclusion: Organisational improvements should be considered a priority when implementing IPC within integrated care initiatives since patient care improvements due to IPC can be expected mainly when organisational aspects are improved. More importantly, the role of financial barriers should be acknowledged, and actions taken to reduce their impact on integrated care.

Leveraging the age friendly healthcare system initiative to achieve comprehensive, hearing healthcare across the spectrum of healthcare settings: an interprofessional perspective

“…The difficulties encountered in developing and implementing interprofessional collaborative teams relate to a number of barriers encountered in clinical settings, including the structure of health care systems, which often makes smooth communication difficult. This can be exacerbated by financial constraints, regulatory processes and concerns about medico-legal issues (Gilles et al 2020;Lahey and Currie 2005).…”

Interprofessional Collaboration in a New Model of Transitional Care for Families with Preterm Infants – The Health Care Professional’s Perspective

“…53 We found HCP needed more human resources to intensively support parents and the changes in IPC, and they thought it might be difficult to implement the model so it is financially sustainable. A recent Swiss study 13 found that financial barriers hindered IPC within integrated care. The current reimbursement system is not designed for integrated care and serves as a macro level barrier.…”

“…The model adheres to principles of integrated care, including interventions and processes to improve interprofessional collaboration between stakeholders in the health care system and ensure that treatment and care of patients is coordinated optimally along the treatment continuum. 13 The "Transition to Home (TtH)" model is designed to optimize transitional care of families with preterm infants between 24 and 35 weeks of gestational age by giving parents and infants structured, individual support, improving parental mental health and competence, promoting the child's development, and optimizing interprofessional collaboration (IPC). This model is based on a German model that supports the families of chronically and severely ill children 14 and on Naylor's "Transitional Care Model" for hospitalized elders, 15 which was developed in the US.…”

Integrated Care in Switzerland: Strengths and Weaknesses of a Federal System

“…Secondary data analyses of this national IC survey explored the influences of organisation and the funding of care on the implementation of interprofessional collaboration. Findings suggested that financial barriers hindered the association of interprofessional collaboration and organisational improvements [42].…”