Table 1 Main characteristics of the two investigated models
Integrated HC | Functional HC | |
|---|---|---|
Characteristics of the healthcare team | ||
Team composition | Nurse and family doctor. | |
Team function | The same healthcare team provides HC and manages patients in the primary care center. | The healthcare team is dedicated exclusively to HC. |
Interprofessional communication | Healthcare professionals are part of the healthcare team regularly managing patients in the primary care center. | Although not managing patients in the primary care center, the HC team is part of the health care staff of the center and their members participate in the center meetings as specialists. |
Training | • Regular training of family doctors, including regular stays at mental health and geriatrics units. • Regular training of nurses. | • Regular training of family doctors, including regular stays at mental health and geriatrics units. • Nursing staff receives additional training regarding the management of chronic patients, fragility, and palliative care. |
Type of professional in each visit | Nurse, family doctor or both | |
Services and visit schedule | ||
Preventive visits | • Visits of nursing staff scheduled based on the monitoring requirements of each disease as established by local guidelines. • Visits of physician scheduled at physician’s discretion based on the disease progression and clinical status of patients. | |
Non-urgent acute visits | The patient calls the center and the physician available at that moment (not always the one regularly visiting the patient at the primary care center) visits the patient at home. | • During working hours: the patient contacts directly the physician of the HC team. • Outside the working hours: the patient calls the center and the physician available at that moment (not always the one regularly visiting the patient at the primary care center) visits the patient at home. |
Urgent visits | The patient calls the emergency service; an emergency team and an ambulance are deployed to patient’s home. | |
Financial approach | All visits are fully covered by the public health system. | |