Caring for patients with chronic and multiple health conditions: An exploratory qualitative study of the processes of an integrative model of care, of patients’ and team experiences in Chile and Switzerland.
The healthcare of persons with multiple and chronic healthcare conditions (PCMC) is a worldwide health policy priority. The Swiss government has promoted reforms in the healthcare system and the care of PCMC encouraging better interprofessional care, closer partnership with the PCMC, and a stronger focus towards the community care. These measures represent some components of the chronic care model (CCM), promoted by the WHO for two decades to enhance care for PCMC. Barriers associated to the implementation of the different measures, a strong focus on hospital care, and financial inadequacy still impede optimal care to PCMC in Switzerland. Switzerland could benefit from lessons learned in another country (i.e. Chile) that has implemented since 2011 a national strategy for PCMC oriented by the CCM showing encouraging results in terms of admission, length of stay and follow-up. The aims of this study consist in a) the observation and comprehensions of the process of application of the components of CCM in Chile and in Switzerland, in the community setting; and b) the identification of the determinants and processes contributing to the success or barrier to the care of PCMC that Switzerland could adapt to the Swiss healthcare culture.