Healthcare system maturity for integrated care: results of a Swiss nationwide survey using the SCIROCCO tool

Abstract

ObjectivesTo assess the maturity of the Swiss healthcare system for integrated care and to explore whether this maturity varied according to several variables.DesignA Swiss nationwide individual electronic survey in November 2019.Setting and populationStakeholders identified via lists of the Swiss Forum for Integrated Care and of the integrated care unit of the Swiss Federal Office of Public Health, and representatives of 26 cantonal public health departments, were invited to participate.Primary outcome measureThe outcome was the maturity of the Swiss healthcare system for integrated care, measured with the Scaling Integrated Care in Context maturity model tool (SCIROCCO tool), which comprises 12 dimensions and questions rated on a 6-point scale.AnalysisUnivariate analyses were first performed, followed by bivariate analyses, to find out whether maturity varied according to working linguistic region, healthcare profession, main domain of professional activity, implication in integrated care, attitude towards integrated care and attitude towards the Swiss healthcare system.ResultsThe 642 respondents were 53.7 years on average, 42.5% were women, 60.0% and 20.7% worked in the German and French-speaking parts of Switzerland, respectively. Overall, the maturity of the Swiss healthcare system for integrated care was evaluated as low, with dimension means ranging from 1.0 (±1.0) for the ‘Funding’ dimension to a maximum of 2.7 (±1.1) for ‘eHealth Services’. Results only varied according to the working linguistic region.ConclusionsResults highlight a limited maturity of the Swiss healthcare system for integrated care, as assessed at a national level by a large and varied number of healthcare stakeholders. They represent important information for the further development of integrated care in Switzerland, and should help identify areas requiring attention for a successful transformation of the Swiss healthcare system towards more integrated care.

Healthcare stakeholders' perspective on barriers to integrated care in Switzerland: Results from the open‐ended question of a nationwide survey

“…The open‐ended question was included in a cross‐sectional national survey conducted in Switzerland in the fall of 2019, with local healthcare stakeholders selected for their potential knowledge and experience of integrated care 10 . The survey was composed of three sections.…”

“…[6][7][8][9] Considering that barriers to IC are context-specific and that the healthcare context has evolved a lot during the past decade, in terms of the burden of chronic diseases and the required shift in the chronic care paradigm, health policy targets and initiatives, an updated exploration of barriers to IC is appropriate to explore specificities in the swiss healthcare context. 10 The SCIROCCO tool, based on the B3-Maturity Model, 11 has been used to evaluate the maturity of health systems to deliver IC, by revealing their strengths, weaknesses and areas for improvement, through stakeholders' perspectives. 10,12,13 Recently, the SCIROCCO tool was included in a national survey to assess the "maturity" of the Swiss health system for IC.…”

“…10,12,13 Recently, the SCIROCCO tool was included in a national survey to assess the "maturity" of the Swiss health system for IC. 10 Results from this survey confirmed, at the national level, a rather low maturity of the Swiss health system to implement IC on each of the 12 dimensions. The objective of the current study is to understand these quantitative results.…”

“…10 The SCIROCCO tool, based on the B3-Maturity Model, 11 has been used to evaluate the maturity of health systems to deliver IC, by revealing their strengths, weaknesses and areas for improvement, through stakeholders' perspectives. 10,12,13 Recently, the SCIROCCO tool was included in a national survey to assess the "maturity" of the Swiss health system for IC. 10 Results from this survey confirmed, at the national level, a rather low maturity of the Swiss health system to implement IC on each of the 12 dimensions.…”

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

“…A more recent nationwide survey showed that the Swiss healthcare system's readiness for IC could be improved [43]. Indeed, seven of the SCIROCCO tool's [44] twelve items were rated as low (Readiness to Change, Structure and Governance, Standardisation and Simplification, Funding, Breadth of Ambition, Innovation Management and Capacity Building).…”