Integration of health care in Euskadi: qualitative research and diagnosis of the implementation process of Osakidetza-Basque Health System

This article analyzes the health care integration process implemented in the Basque Country (Spain) within its public health system (Osakidetza – an international benchmark), as well as the perception of people leading it. The integration process is necessary in the current context and it proposes to intervene with a broad vision on the health of citizens, which requires rejecting a limited vision of health in favor of a coordinated and transversal work of the health system with other public administrations and social agents. The new model aims to move towards a proactive and much more patient-centered system and implies a significant change in its structures and care tools. A qualitative methodology applied consists on a case study based on in-depth interviews. The research enables to identify its strengths and to detect the key elements to improve. Among these factors, we can identify the Integrated Sanitary Organization (ISO), the integrated information and ICT systems, the new roles of nurses, the program contract, as well as the changes addressed to the empowerment of the patient and to the coordination among professionals as well as among the community and social ambit.