Integrated care in Switzerland: Results from the first nationwide survey
Integrated care in Switzerland: Results from the first nationwide survey
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瑞士的综合护理： 首次全国性调查的结果
DOI：
10.1016/j.healthpol.2018.03.006
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发表时间：
2018-06-01
期刊：
影响因子：
3.3
通讯作者：
Peytremann-Bridevaux, Isabelle
中科院分区：
文献类型：
--
作者：
Filliettaz, Severine Schussele;Berchtold, Peter;Peytremann-Bridevaux, Isabelle
导言：由于保健服务的分散，卫生系统面临压力，提倡综合保健。相比，在欧洲和其他地方的许多现有的综合护理举措，瑞士似乎落后于。方法：调查的目的是产生一个全面的概述，在瑞士的综合护理举措。要纳入，倡议需要满足四个标准：提出某种形式的正式化，考虑>2个不同的医疗保健专业人员群体，整合>2个医疗保健水平，持续进行。我们系统地联系了联邦、州和地方各级的主要卫生系统组织。在2015年至2016年期间，我们确定了172项综合护理举措，并向他们发送了一份调查问卷。我们进行了描述性analysis.Results：在瑞士的综合护理举措是频繁和不断增加。随着时间的推移，他们的语言区域之间的分布，整合的医疗保健水平的数量，以及参与的专业人员的数量根据initiations.Discussion的类型而有所不同的倡议的实施：尽管瑞士的联邦制结构和医疗保健的组织，只有最近的激励措施，以发展综合护理，倡议是频繁和多样的。利益攸关方应支持现有举措并促进其发展。它们还应促进创新途径，试验综合护理的替代支付模式，促进以人为本，并激励跨专业模式。这将需要系统思维和医疗保健系统所有参与者的贡献。(C)2018爱思唯尔B.V.保留所有权利。
Introduction: Due to fragmentation of care delivery, health systems are under pressure and integrated care is advocated for. Compared to the numerous existing integrated care initiatives in Europe and elsewhere, Switzerland seems to lag behind.Methods: The objective of the survey was to produce a comprehensive overview of integrated care initiatives in Switzerland. To be included, initiatives needed to meet four criteria: present some type of formalization, consider >2 different groups of healthcare professionals, integrate >2 healthcare levels, be ongoing. We systematically contacted major health system organizations at federal, cantonal and local level. Between 2015 and 2016, we identified 172 integrated care initiatives and sent them a questionnaire. We performed descriptive analyses.Results: Integrated care initiatives in Switzerland are frequent and increasing. The implementation of initiatives over time, their distribution between linguistic areas, the number of healthcare levels integrated, and the number of professionals involved vary according to the type of initiatives.Discussion: Despite Switzerland's federalist structure and organization of healthcare, and only recent incentives to develop integrated care, initiatives are frequent and diverse. Stakeholders should support existing initiatives and facilitate their development. They should also promote innovative avenues, experiment alternative payment models for integrated care, foster people-centeredness and incentivize interprofessional models. This will require systems thinking and contributions from all actors of the healthcare system. (C) 2018 Elsevier B.V. All rights reserved.