Continuity of care is the set of processes implemented in an integrated way by the health system in order to offer the patient the health care they need regardless of the health system (public or private). However, reality today does not respond to this theoretical definition, since there are protocols that do not prioritize the patient and there is a lack of synergies between levels of care or provision systems.
In this sense, “from the IDIS Foundation we consider that establishing continuity of care in our health system is essential. It is not an option, it is an obligation that directly impacts the right of patients to move freely through the system, seeking the best results for their medical problem. With this, we would be able to reduce the healthcare pressure of the public system, we would avoid redundancies, and we would facilitate the task of physicians, undoubtedly improving the patient experience, as well as health and health outcomes. For this to happen, it is necessary to have interoperability tools and proposals for change that allow us to reach it and promote cooperation between private and public health to promote a more sustainable, synergistic and efficient health and socio-health model. In other words, it is necessary for the patient to be one in the entire health system and all our efforts go to their benefit,” he assured. Juan Abarcapresident of the Institute for the Development and Integration of Health (IDIS Foundation), during the IDIS Conference: Continuity of care and single patient, in which the results of the report of the same name were presented.
The analysis, carried out by Accenture for the IDIS Foundation, collects the perception and opinion of patients -a survey carried out by sigma two 3,000 people- and professionals -7 interviews with health professionals, of which 5 have been with medical professionals from different specialties and 2 with oncologists- in relation to aspects related to the aforementioned continuity of care. In addition, it develops a use case of a patient with breast cancer to show the existing breaking points and make some proposals in favor of the patient and the efficiency of the system.
The results of the survey reveal that 70.2% consider it essential to promote cooperation between private healthcare and public healthcare to promote a more sustainable healthcare and social healthcare model. Likewise, 85% of the population considers receiving treatment or having tests in public and private health very positive, quite positive and positive, and that all the data can be recognized and evaluated by the health professional who attends them at all times.
In addition to these data, in the «Report on the social perception of cancer in Spain»carried out by the ECO Foundation within its project «Cancer Now», it is observed that 40% of the population considers that early detection is the most relevant area in cancer, followed by research; They also point out that 69% consider that the administrations do not provide health professionals with the necessary resources to deal with cancer and 60% think that cancer treatment is not equitable between the different Autonomous Communities.
The professionals, for their part, consider that for continuity of care to exist, it is necessary to place the patient as backbone, being the system the one that adapts to the patient and not the other way around; it is necessary to establish synergies between levels, break territorial barriers and normalize the private sector as part of the health system.
The general director of the IDIS Foundation, Marta Villanueva, explained that “along with the assessments of patients and professionals, a study has been carried out to analyze the journey of the patient with breast cancer with the aim of seeing what are the the breaking points that may exist in the care process, in order to seek solutions and analyze what impact it would have on the patient, on the healthcare professional and on the system if these problems were mitigated».
Regardless of how the patient transits through the health system, it is observed that there are 6 breakpointswhich are sometimes shared in the public system, in the private system or when a patient changes from one to another: lack of integrated prevention programs and also of personalization, loss of information traceability, lack of homogeneous protocols and harmonization of support structures, duplication of appointments and tests and the lack of access to innovative treatments.
In order for continuity of care to exist, it is necessary to place the patient as the backbone
The analysis of all the information collected allows 3 proposals to be made in order to improve the patient’s journey from its beginning -both at the diagnostic and treatment level-, to the follow-up and control after overcoming the disease and thus achieve continuity of care. real. Thus, the report proposes creating a Integrated strategy of prevention plans (primary and secondary) and health promotion to prepare professionals to identify risk variables and activate specific early detection programs when necessary and in a homogeneous manner.
Likewise, it advocates the creation of mixed committees by health areas for therapeutic and research purposes, facilitating the provision of treatment or inclusion in a clinical trial based on clinical evidence in a protocolized manner.
Finally, it is proposed to generate integrated structures with multidisciplinary support groups as a fundamental tool to put different services and specialties in contact with the aim of providing the best therapeutic alternative for patients. All of this will result in greater patient support throughout their care journey.