Conditioning factors for integrated care development in Osakidetza (Basque Health Service)

O+Berri, along with MSD and the University of Miguel Hernandez de Elche has developed the ARCHO instrument (Assessment of Readiness for Chronicity in Health Care Organisations) based on the "Chronic Care Model” that allows self-assessment of healthcare organisations with respect to their degree of readiness to provide integrated care to cope with chronicity. It has been used in several Basque healthcare organisations. Aims: Analyse the origin of the observed differences in the score for each organisation, trying to identify the underlying organisational and professional factors that explain those variations. Method: A quantitative research with 164 professionals from the 7 health organisations involved in self-assessment has been conducted. For that purpose, we have designed a questionnaire that attempt to assess the possible effect of the following variables: structural and functional integration of the organisation, leadership style, professional training and attitudes towards the development of integrated care. Results: The level of functional integration, the leadership style as well as professional attitudes are related to the ability to provide integrated care shown by the organisations evaluated. Conclusions: The variables identified jointly explain an appreciable amount of variation in the organisations scores. However, more research is needed concerning both organisational and professional factors that might underlie the implementation of integrated models for chronic patients.