Peytremann-Bridevaux Isabelle, Schusselé Filliettaz Séverine, Berchtold Peter, Grossglauser Michelle, Pavlickova Andrea, Gilles Ingrid
Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
Association for the promotion of integrated patient care networks (PRISM), Geneva, Switzerland.
BMJ Open. 2021 Feb 23;11(2):e041956. doi: 10.1136/bmjopen-2020-041956.
To assess the maturity of the Swiss healthcare system for integrated care and to explore whether this maturity varied according to several variables.
A Swiss nationwide individual electronic survey in November 2019.
Stakeholders 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.
The 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.
Univariate 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.
The 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.
Results 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.
评估瑞士医疗保健系统在综合照护方面的成熟度，并探讨这种成熟度是否因若干变量而有所不同。
2019年11月在瑞士全国范围内进行的个人电子调查。
通过瑞士综合照护论坛和瑞士联邦公共卫生办公室综合照护部门的名单确定利益相关者，并邀请26个州公共卫生部门的代表参与。
结局是瑞士医疗保健系统在综合照护方面的成熟度，使用情境下综合照护成熟度模型工具（SCIROCCO工具）进行衡量，该工具包括12个维度和按6分制评分的问题。
首先进行单变量分析，然后进行双变量分析，以了解成熟度是否因工作语言区域、医疗保健职业、专业活动的主要领域、在综合照护中的参与程度、对综合照护的态度以及对瑞士医疗保健系统的态度而有所不同。
642名受访者的平均年龄为53.7岁，42.5%为女性，分别有60.0%和20.7%在瑞士德语区和法语区工作。总体而言，瑞士医疗保健系统在综合照护方面的成熟度被评估为较低，各维度的均值从“资金”维度的1.0（±1.0）到“电子健康服务”维度的最高2.7（±1.1）不等。结果仅因工作语言区域而有所不同。
结果凸显了瑞士医疗保健系统在综合照护方面的成熟度有限，这是由大量不同的医疗保健利益相关者在国家层面评估得出的。它们为瑞士综合照护的进一步发展提供了重要信息，并应有助于确定瑞士医疗保健系统成功向更综合照护转型所需关注的领域。
