Room
Salle Paros ( traverser la route - bâtiment de liaison )
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Theme
Health care - New results from Health Care Research
Chair
Valérie Clerc
Title
Erste Daten zur professionellen Gesundheitskompetenz von Gesundheitsfachpersonen in der Schweiz
Name
Rebecca Jaks
Affiliation
Careum Zentrum für Gesundheitskompetenz
Abstract
HintergrundDa Gesundheitsfachpersonen die wichtigste Anlaufstelle bei Gesundheitsfragen sind, übernehmen sie bezüglich Stärkung der Gesundheitskompetenz (GK) der Bevölkerung eine wichtige Aufgabe. Damit sie dazu beitragen können, müssen sie ihrerseits über die dazu nötigen Kompetenzen verfügen.
Ziel
Ziel dieser Studie war es herauszufinden, mit welchen Schwierigkeiten Gesundheitsfachpersonen (1) in ihrem Informations- und Wissensmanagement, (2) bei der Kommunikation mit Patient:innen sowie (3) bei der Vermittlung von Informationen konfrontiert sind. Dies sind wichtige Aspekte, wenn es um die Adressierung und Förderung der GK der Patient:innen geht.
Methoden
Zur Bestimmung der professionellen GK wurde im Rahmen einer Drei-Länder-Studie ein entsprechendes Konzept und Erhebungsinstrument entwickelt. In der Schweiz wurden damit total 1'613 Apotheker:innen, Ärzt:innen, Pflegekräfte und Physiotherapeut:innen befragt. Die inhaltlichen Fragen zur professionellen GK wurden in total acht Teilbereiche gruppiert und zu Scores zusammengefasst.
Resultate
Von den acht Teilbereichen der professionellen GK fällt den Gesundheitsfachpersonen das Ermitteln von Kommunikationsvoraussetzungen und -fähigkeiten der Patient:innen am schwersten. Weiter sind herausfordernde Situationen bei der Informationsvermittlung (z.B. Umgang mit fehl- oder falschinformierten Patient:innen) schwierig. Auch machen digitale Aufgaben im Zusammenhang mit der professionellen GK den Vertreter:innen aller Fachbereiche zu schaffen. Hingegen berichten sie weniger Schwierigkeiten bei der patientenzentrierten Gesprächsführung. Insgesamt bekunden die Ärzt:innen in den meisten Aufgaben vergleichsweise weniger Mühe als andere Fachpersonen. Weiter finden vor allem Pflegkräfte häufiger Bedingungen vor, die weniger ideal für eine gesundheitskompetenzfördernde Kommunikation sind. Zudem sind die befragten Gesundheitsfachpersonen der Meinung, dass die absolvierte Ausbildung sie oftmals (zu) wenig auf die Kommunikation mit den Patient:innen und die Wissensvermittlung vorbereitet hat.
Diskussion
Die Ergebnisse zeigen einen klaren Handlungsbedarf. Die Gesundheitsfachpersonen benötigen in diversen Bereichen Unterstützung, um die wichtige Rolle bei der Förderung der GK ihrer Patient:innen übernehmen zu können. Es sind deshalb Massnahmen auf der strukturellen und organisationalen Ebene gefragt. So sollte GK u.a. systematisch in die Aus- und Weiterbildung von Gesundheitsprofessionen integriert werden.
Title
Swiss COhort of Healthcare Professionals & Informal CAregivers (SCOHPICA): Description & first results
Name
Vladimir Jolidon
Affiliation
Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne
Abstract
Background: The COVID-19 pandemic aggravated health workforce problems, such as low job satisfaction, burnout and personnel shortages. Swiss healthcare stakeholders called to solve the health workforce crisis, and stressed that current data on working conditions and trajectories of healthcare professionals (HCPs) is insufficient.Aims: The Swiss COhort of Healthcare Professionals and Informal Caregivers (SCOHPICA) was designed to study the trajectories, intentions to leave/stay in the job/profession, and well-being of HCPs, as well as their determinants. This presentation describes the design and methods, the HCPs baseline survey main results, and SCOHPICA’s perspectives.
Design: SCOHPICA is a prospective open cohort with an embedded mixed study design. The baseline survey took place from October 1, 2022 to January 31, 2023 using an electronic self-reported questionnaire. Follow-up surveys will be held once a year, including an online life history calendar (LHC) in 2023. Participants will be invited to attend biennial focus groups or interviews.
Population: Any type of HCP working in contact with patients, in any healthcare setting and sector in Switzerland (irrespective of employment status) is eligible. A minimum of 1500 HCPs was targeted.
Measures: Outcome variables are trajectories, intentions to leave/stay in job/profession and well-being, and independent variables are organizational (e.g. leadership, workload), psychosocial (e.g. sense of belonging, recognition), psychological (e.g. burnout, resilience), occupational (e.g. current job, specialization) and sociodemographic determinants.
Statistical Analyses: Descriptive and regression analyses will be used to examine baseline data, and sequence analysis and clustering for longitudinal data. Interpretative phenomenological analysis and solution-focused approaches will be applied for qualitative analyses.
Results: On January 19, 2023, 1727 HCPs had already responded. First results will be presented at the conference.
Conclusions: SCOHPICA uses an innovative methodology to collect nationwide and longitudinal data on all types of HCPs. This data, which will be made publicly available online, is essential both to monitor, plan and manage the health workforce, and for policy interventions to promote a health system capable of delivering high quality of care. This data will be complemented by data collected among informal caregivers, key but often neglected health system actors, who will be recruited in spring 2024.
Title
The cost and value of physiotherapy in Switzerland: a health systems perspective
Name
Anna Nicolet
Affiliation
Centre universitaire de médecine générale et santé publique, Unisanté, Lausanne, Switzerland
Abstract
Background: The expenditure for physiotherapy treatments in Switzerland grew substantially over the last years, well above the average growth rate of total healthcare expenditures. This raises questions about the type of needs such an increase in physiotherapy volumes meets, the integration of physiotherapy with other types of healthcare provision (primary and secondary care, as well as specialized rehabilitation treatments) and to the financial viability of further growth in physiotherapy costs. For these reasons, a group of researchers from various academic institutions in the three language regions across Switzerland joined forces in a research project, aiming to explore the positions of key stakeholders and policymakers regarding the cost and value of physiotherapy in Switzerland, and to identify key research gaps.
Methods: In a first project stage, we identified and ranked potential cost drivers and benefits of physiotherapy by (a) running a focus group among project members and (b) inviting a selected sample of 28 stakeholders and policymakers to a short online survey and ranking exercise. Building on the results of the first stage, we invited 12 key stakeholders from various language regions with different roles to participate in semi-structured interviews for further exploration. The findings of the interviews – ongoing as of February 2023 - will be summarized in a preliminary report and will be validated by the stakeholders. In a final workshop, the report will be debated in a stakeholder dialogue involving a larger group of public stakeholders interested in physiotherapy policymaking.
Results: The preliminary results – emerging from the first stage of the project – suggest that changes in the demographic structure, shorter length of hospital stays and a shift from inpatient to outpatient care were identified as main drivers of cost related to physiotherapy treatment. The main values of physiotherapy were the potential for improvements in health outcomes and health-related quality of life and the potential of being a cost-effective alternative to surgery for specific conditions. At the time of the Swiss Public Health Conference 2023, the results of the semi-structured interviews with stakeholders will be available.
Conclusion: Understanding the position of stakeholders regarding the cost drivers and the value of physiotherapy for population health would be of high relevance for the current policy challenges regarding physiotherapy in Switzerland.
Title
Implementation of Case Management in emergency departments: the influencing factors
Name
Elodie Schmutz
Affiliation
Department of Vulnerabilities and Social Medicine, Center for Primary Care and Public Health, Chair of Medicine for Vulnerable Populations, University of Lausanne, Switzerland
Abstract
Introduction: Frequent users of Emergency Departments (ED; ≥ 5 ED visits in the previous 12 months) often cumulate somatic, psychological and addiction problems. The provision of a Case Management (CM) intervention reduces their number of ED visits and improves their quality of life. However, there is limited knowledge about the implementation process of CM. This study aimed to identify the facilitators, barriers and needs during the CM implementation in the context of a larger study that attempted to implement CM in EDs throughout French-speaking Switzerland.
Method: Mixed-method research was conducted with ED staff involved in CM implementation who completed a questionnaire (N = 31) and took part in semi-structured interviews (n = 23) assessing influencing factors for implementation. Quantitative data were analyzed with Kruskal-Wallis one-way tests, whereas qualitative data were subject to an inductive content analysis.
Results: Using several dimensions of the RE-AIM framework, ED sites were split into two groups: more and less successful sites. The success of the CM implementation was significantly associated with the perception of acceptability (x2 (2, n=30)=14.39, p=.045), appropriateness (x2 (2, n=30)=15.36, p=.032) and feasibility (x2 (2, n=30)=17,25, p=.016). Qualitative findings revealed four main facilitators: 1) Direct hierarchy support and flexibility; 2) Exchange with colleagues; 3) Supervision by the research team; and 4) Motivation. Lack of resources was an unanimously mentioned barrier. Participants identified the following needs to enable CM implementation: official and protected time for the project and at least two team members with complementary skills (e.g.: somatic, psychiatric and social).
Conclusion: The positive perception of the CM implementation by the professionals contributed to the success of the implementation process. However, human and logistical resources were found as crucial. Our findings highlight that key factors for a successful CM implementation are both individual and structural.