Healthcare integration process helped ensure better management of the COVID-19 pandemic

Due to the ongoing aging of the population and the increase in the number of chronic, multi-morbid patients, healthcare systems in many advanced societies are urgently in need of a thorough overhaul.

The Public Health System in the Autonomous Community of the Basque Country (known locally as Osakidetza) is currently immersed in a process of integrating the healthcare services it provides in order to offer better patient care and better continuity and coordination between the different levels (primary, hospital care, etc.), using a series of tools.

The health management integration process is essential to providing high-quality, sustainable healthcare at all moments; but in the event of a health emergency, such as the COVID-19 pandemic, it is more important than ever to move towards a model that puts patients at the center."

Julen Izagirre Olaizola, Researcher, Department of Financial Economics II at the UPV/EHU-University of the Basque Country

This is even more necessary in relation to primary care, since this is the first service to come under pressure during health emergencies such as the recent COVID-19 crisis. Consequently, 'this study aimed to analyze the healthcare integration process being followed by Osakidetza and to determine whether the measures adopted to date helped or hindered the work of healthcare professionals during the recent pandemic,' adds Julen Izagirre Olaizola.

'We conducted a series of case studies and held in-depth interviews with three types of people directly involved in both the integration process and the fight against the COVID-19 virus: management staff, healthcare professionals and patients,' adds the researcher from the UPV/EHU-University of the Basque Country.

According to Izagirre 'the study makes two fundamental contributions to the extant literature. Firstly, it analyses the healthcare integration process carried out over recent years in the Basque Public Health System; and secondly, it presents the first-hand accounts and perceptions of different stakeholders in the Basque Health System regarding whether or not the tools implemented during the integration process were effective during the pandemic'.

'The results obtained confirm that we are making headway in rising to the current and future challenges facing the healthcare system, although there is still much work to be done. The aim is to develop a proactive system much more focused on patients themselves and which promotes tele-medicine and hospital-at-home models, etc. The system has a series of shortcomings and imbalances that need to be addressed, particularly given the rising rates of dependency, chronicity and aging. The most critical informants said they believed that decision-making and resource allocation had been overly concentrated in hospitals, with primary care gradually losing resources and decision-making capacity,' he adds.

The study also highlights the need for true coordination. 'The ultimate aim of any healthcare system should be to achieve real, effective coordination between the different levels of care: primary care, hospital care, etc.,' explains the researcher at the UPV/EHU-University of the Basque Country.

'Primary care should have sufficient resources, adequate conditions and, above all, the decision-making and management capacity it needs to cope with extreme situations. If the healthcare integration process aims to promote health by reducing hospital admissions, then we need a high-quality primary care system which has more responsibility and more weight,' concludes Julen Izagirre Olaizola.