Community Health Centre Ljubljana, Ljubljana, Slovenia.
Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
BMC Health Serv Res. 2023 Apr 12;23(1):362. doi: 10.1186/s12913-023-09353-3.
Integrated care involves good coordination, networking, and communication within health care services and externally between providers and patients or informal caregivers. It affects the quality of services, is more cost-effective, and contributes to greater satisfaction among individuals and providers of integrated care. In our study, we examined the implementation and understanding of integrated care from the perspective of providers - the health care team - and gained insights into the current situation.
Eight focus groups were conducted with health care teams, involving a total of 48 health care professionals, including family physicians, registered nurses, practice nurses, community nurses, and registered nurses working in a health education center. Prior to conducting the focus groups, a thematic guide was developed based on the literature and contextual knowledge with the main themes of the integrated care package. The analysis was conducted using the NVivo program.
We identified 12 main themes with 49 subthemes. Health care professionals highlighted good accessibility and the method of diagnostic screening integrated with preventive examinations as positive aspects of the current system of integrated care in Slovenia. They mentioned the good cooperation within the team, with the involvement of registered nurses and community nurses being a particular advantage. Complaints were made about the high workload and the lack of workforce. They feel that patients do not take the disease seriously enough and that patients as teachers could be useful.
Primary care teams described the importance of implementing integrated care for diabetes and hypertension patients at four levels: Patient, community, care providers, and state. Primary care teams also recognized the importance of including more professionals from different health care settings on their team.
整合照顾涉及医疗服务内部以及提供者与患者或非正式照护者之间的良好协调、网络和沟通。它影响服务质量，更具成本效益，并有助于提高整合照顾者和接受者的满意度。在我们的研究中，我们从提供者（医疗保健团队）的角度审视了整合照顾的实施和理解，并深入了解了现状。
我们对医疗保健团队进行了八次焦点小组讨论，共有 48 名医疗保健专业人员参加，包括家庭医生、注册护士、执业护士、社区护士和在健康教育中心工作的注册护士。在进行焦点小组讨论之前，根据文献和背景知识制定了一个主题指南，主题包括整合照顾套餐的主要主题。使用 NVivo 程序进行分析。
我们确定了 12 个主要主题和 49 个子主题。医疗保健专业人员强调了良好的可及性和将诊断筛查与预防性检查相结合的方法，这是斯洛文尼亚当前整合照护系统的积极方面。他们提到了团队内部的良好合作，注册护士和社区护士的参与是一个特别的优势。他们抱怨工作量大，人员不足。他们认为患者对疾病不够重视，患者作为教师可能会有所帮助。
初级保健团队描述了在四个层面实施糖尿病和高血压患者整合照护的重要性：患者、社区、照护提供者和国家。初级保健团队还认识到在团队中纳入来自不同医疗保健环境的更多专业人员的重要性。
