[Integrated delivery systems and other examples of collaboration among providers. SESPAS report, 2012].
Because of the steady increase in healthcare complexity, due to high specialization and the involvement of a number of services, as well as the increase in patients with chronic diseases and pluripathology, coordination has become a high-priority need in healthcare systems. The distinct regional services that comprise the decentralized Spanish National Health System have developed a number of experiences to improve collaboration among the providers involved in the healthcare process. The present article aims to analyze the experiences with integrated healthcare providers in Catalonia and the Basque Country and the chronic diseases programs of the latter. In Catalonia, which promoted the purchaser-provider split and maintained diversity in providers' ownership, organizations were slowly created that manage the provision of the healthcare continuum, known as integrated healthcare organizations (IHO). These organizations have evolved and, despite some common characteristics, they also show some differences, such as the emphasis on formal instruments or on coordination mechanisms and organic structures. This is also reflected in their results regarding culture and perceived coordination across the organization. In the Basque Country, in addition to the establishment of an IHO, a variety of integration experiences have been developed to improve the care of chronic diseases.
Grup de Recerca en Polítiques de Salut i Serveis Sanitaris, Servei d'Estudis i Prospectives en Polítiques de Salut, Consorci de Salut i Social de Catalunya, Barcelona, España. mlvazquez@consorci.org
M Luisa
ML
Vázquez
Ingrid
I
Vargas
Roberto
R
Nuño
Nuria
N
Toro
D002908:Chronic Disease; D003191:Comprehensive Health Care / Q000458:organization & administration; D003299:Cooperative Behavior; D003469:Culture; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006282:Health Personnel; D006292:Health Priorities; D017146:Models, Organizational; D009313:National Health Programs / Q000458:organization & administration*; D010346:Patient Care Management; D011057:Politics; D013030:Spain; D019472:Universal Health Insurance