Integrated care for patients with multimorbidity in Switzerland: a qualitative study of general practitioners’ perspectives
Type
working paper
Date Issued
2026-10-01
Author(s)
Abstract
Background
Integrated care has been proposed as a solution for the Swiss health system to maintain high quality of care while containing costs, particularly for managing individuals with multimorbidity. Translating this concept into practice requires understanding and engaging the general practitioners (GPs), who bear primary responsibility for its implementation in this patient group. This study therefore explored how integrated care is practiced and experienced by Swiss GPs.
Methods
This qualitative study was based on semi-structured interviews with 12 GPs in the canton of Zurich, purposively sampled to capture variation. Interviews took place between April and June 2025. Data were analyzed using thematic analysis, drawing on the Rainbow Model of Integrated Care, which distinguishes four interrelated dimensions of integration: clinical, professional, organizational, and system integration.
Results
Participants described various ways of delivering care that reflected elements of integrated care, most commonly at the clinical and professional dimension (continuity of care, coordinator roles; collaboration and communication among health professionals, adapted to context and available personnel). Organizational and system-level integration (collaboration across institutions; cross-sectoral governance and regulatory arrangements) were discussed less frequently. Facilitators and barriers to integrated care emerged on three interconnected levels: individual (e.g., attitudes of patients and providers), interpersonal (e.g., frequency of contact and trust between actors), and structural level (e.g., shared information systems, appropriate financing systems, and workforce availability).
Conclusions
Our findings suggest that GPs implement various elements of integrated care, mainly within the clinical and professional dimensions, while broader organizational and system-level integration remains limited. At the same time, there appears to be no single optimal model of integrated care. Given the identified facilitators and barriers, strengthening integrated care requires greater opportunities for exchange and improved coordination across sectors alongside supportive financing, digital communication, and workforce structures.
Integrated care has been proposed as a solution for the Swiss health system to maintain high quality of care while containing costs, particularly for managing individuals with multimorbidity. Translating this concept into practice requires understanding and engaging the general practitioners (GPs), who bear primary responsibility for its implementation in this patient group. This study therefore explored how integrated care is practiced and experienced by Swiss GPs.
Methods
This qualitative study was based on semi-structured interviews with 12 GPs in the canton of Zurich, purposively sampled to capture variation. Interviews took place between April and June 2025. Data were analyzed using thematic analysis, drawing on the Rainbow Model of Integrated Care, which distinguishes four interrelated dimensions of integration: clinical, professional, organizational, and system integration.
Results
Participants described various ways of delivering care that reflected elements of integrated care, most commonly at the clinical and professional dimension (continuity of care, coordinator roles; collaboration and communication among health professionals, adapted to context and available personnel). Organizational and system-level integration (collaboration across institutions; cross-sectoral governance and regulatory arrangements) were discussed less frequently. Facilitators and barriers to integrated care emerged on three interconnected levels: individual (e.g., attitudes of patients and providers), interpersonal (e.g., frequency of contact and trust between actors), and structural level (e.g., shared information systems, appropriate financing systems, and workforce availability).
Conclusions
Our findings suggest that GPs implement various elements of integrated care, mainly within the clinical and professional dimensions, while broader organizational and system-level integration remains limited. At the same time, there appears to be no single optimal model of integrated care. Given the identified facilitators and barriers, strengthening integrated care requires greater opportunities for exchange and improved coordination across sectors alongside supportive financing, digital communication, and workforce structures.
HSG Classification
contribution to practical use / society
Refereed
No
Publisher
Springer Science and Business Media LLC
Subject(s)
Division(s)