Spitex: part of integrated care

However, the real core of integrated care is the solution to a very specific problem: the ageing of the population. Due to ever-improving medical possibilities and living conditions, the Swiss are becoming increasingly older. This is, of course, a very welcome development. However, it presents the healthcare system with a major challenge.

With increasing age, the need for medical and nursing care in everyday life also increases. In order to meet these needs, greater networking in the healthcare system is required. In this way, the treatment and care pathway can be better coordinated.

However, the ageing population is not the only challenge facing the Swiss healthcare system. There are also aspects such as:

• Staff shortages
• advancing digitalization, with which healthcare professionals and patients must familiarize themselves
• Medical options are increasing, but the financial resources to implement them are limited or non-existent
• Securing basic care in rural areas

Thanks to interprofessional and patient-centered approaches, it is possible to call in the appropriate specialist support at the right time and in the right place. This improves the quality of treatment across the entire supply chain.

The basic idea of integrated care consists of three pillars. The patients themselves, the benefits for them and the effectiveness and efficiency of care make up the so-called Triple Aim concept. More and more members of the healthcare sector are adopting this approach, making the concept an important driver of value-based healthcare.

In order to do justice to this concept, the institutions and specialists within a healthcare sector are networking. This networking remains in place throughout the entire treatment period. All those involved pursue jointly agreed treatment processes, quality guidelines and goals.

At the beginning of the 1990s, integrated care increasingly reached the Swiss healthcare system. The pioneers were group practices and networks of doctors, which even then operated according to the gatekeeping principle. A qualified doctor - often the family doctor - specifically manages the provision of services.

He or she is the first point of contact if a patient is lacking something and takes on a pioneering role. They therefore act as gatekeepers. As such, they direct patients along the care chain according to their complaints.

According to FMH statistics, around 52% of outpatient physicians in Switzerland as a whole were part of a network of doctors in 2017. In primary care, the proportion is even higher at around 70%. However, there are clear regional differences. The majority of physician networks are located in the east or center of Switzerland.

Trend scenarios for integrated care

Integrated care will probably develop differently in the future depending on the environment. Three trend scenarios are therefore under discussion:

1. Rural trend scenario
2. Urban region trend scenario
3. Urban trend scenario

The rural trend scenario is characterized regionally by its seasonally fluctuating population density. It is particularly important to ensure that medical care is provided by an organization to which as many service providers as possible belong. There is little or no competition between them. There will probably be contracts between one organization and several insurers.

The urban region trend scenario, on the other hand, involves an economically significant region with a constant number of more than 150,000 insured persons. Here, it is no longer the securing of care that is of primary importance, as it already exists. The focus is therefore on optimizing it.

There is little competition between the service providers. Due to the higher population density, there will probably not be just one organization with contracts between them and several insured persons.

The third trend scenario, the big city, is characterized by over 300,000 insured persons living there. In direct comparison, the average number of services to be provided will also increase accordingly. For this reason, contracts are also concluded here between several integrated care organizations with several insurers.

As with the urban region scenario, the focus here is also on optimizing care. However, there is a difference in terms of competition. It is significantly greater in the large city trend scenario and may even become the primary control instrument.

Patients are, of course, the focus of any treatment. Within integrated care, however, they are involved particularly intensively. As the entire range of services comes from a single source, it becomes more manageable. Patients find it much easier to follow their treatment.

The use of digital platforms and apps for independent digital processing and coordination of various healthcare services is also helpful. Digital tools are also important channels for the simpler and faster transfer of information. All stakeholders benefit from this - from GPs to hospitals and Spitex organizations to the patients themselves.

Supply chains can thus be designed seamlessly and efficiently. Nevertheless, the healthcare system gains a certain degree of flexibility. Thanks to the rapid transfer of information, even short-term changes can be communicated quickly to all those involved.

Thanks to integrated care models, efficient synergies can be used, which also save costs. Another important advantage is that there are more opportunities for staff to move up and change jobs. Due to the much closer links between different service providers, it is much easier for professionals to establish contacts. In addition, they often find out about vacancies earlier and the changeover is easier.

Integrated care also allows more leeway when drawing up deployment plans. It offers everyone involved a certain degree of flexibility. It makes day-to-day work easier and also enables changes to be made at short notice, which benefits patients.

At the same time, the entire interaction between specialists and patients becomes much more trusting. This is made possible by the intensified involvement of clients, which is so characteristic of integrated care. They know exactly what is happening at all times and are aware of all measures.

Especially when several doctors' surgeries and a hospital or Spitex are involved, patients quickly lose track of things. Thanks to intensive involvement, this is a thing of the past and they feel much more at ease. The medical and nursing staff also benefit from this. They can work more efficiently if there are only a few unanswered questions.

Find Spitex quickly and easily with OPAN®

As already mentioned, digitalization and the associated simplification of numerous processes is an important part of integrated care. This is precisely where OPAN® comes in and provides a platform for online patient registrations for Spitex services.

You, doctors' surgeries or other institutions can use it to reliably transmit your relative's registration to the selected Spitex. A representative of the selected organization will then contact you to discuss the next steps.

We will be happy to answer all your questions about registering your relative for Spitex. Simply get in touch with us. You can reach us by telephone on 031 388 50 25 or by e-mail at support@opanspitex.ch.