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

OBJECTIVES: To assess the maturity of the Swiss healthcare system for integrated care and to explore whether this maturity varied according to several variables. DESIGN: A Swiss nationwide individual electronic survey in November 2019. SETTING AND POPULATION: 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. PRIMARY OUTCOME MEASURE: 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. ANALYSIS: 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. RESULTS: 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. CONCLUSIONS: 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.