Facilitators and Barriers to Scaling-Up Integrated Care for Arterial Hypertension and Type 2 Diabetes in Slovenia: Qualitative Study

Author:

ZAVRNIK Črt12ORCID,STOJNIĆ Nataša1ORCID,MORI LUKANČIČ Majda1ORCID,MIHEVC Matic123ORCID,VIRTIČ POTOČNIK Tina145ORCID,KLEMENC-KETIŠ Zalika125ORCID,POPLAS SUSIČ Antonija12ORCID

Affiliation:

1. 1 Community Health Centre Ljubljana, Primary Healthcare Research and Development Institute , Metelkova ulica 9 , Ljubljana , Slovenia

2. 2 University of Ljubljana, Faculty of Medicine, Department of Family Medicine , Poljanski nasip 58 , Ljubljana , Slovenia

3. 3 Primary Healthcare Centre Trebnje , Goliev trg 3 , Trebnje , Slovenia

4. 4 Primary Healthcare Centre Slovenj Gradec , Partizanska pot 16 , Slovenj Gradec , Slovenia

5. 5 University of Maribor, Faculty of Medicine, Department of Family Medicine , Taborska ulica 8 , Maribor , Slovenia

Abstract

ABSTRACT Introduction Arterial hypertension and type 2 diabetes are significant contributors to global non-communicable disease-related mortality. Integrated care, centred on person-centred principles, aims to enhance healthcare quality and access, especially for vulnerable populations. This study investigates integrated care for these diseases in Slovenia, providing a comprehensive analysis of facilitators and barriers influencing scalability. Methods Qualitative methods, including focus group discussions and semi-structured interviews, were employed in line with the grounded theory approach. Participants represented various levels (micro, meso and macro), ensuring diverse perspectives. Data were collected from May 2019 to April 2020, until reaching saturation. Transcripts were analysed thematically using NVivo software. Results Nine categories emerged: Governance, Health financing, Organisation of healthcare, Health workforce, Patients, Community links, Collaboration/Communication, Pharmaceuticals, and Health information systems. Some of identified barriers were political inertia and underutilisation of research findings in practice; outdated health financing system; accessibility challenges, especially for vulnerable populations; healthcare workforce knowledge and burnout; patients’ complex role in accepting and managing their conditions; collaboration within healthcare teams; and fragmentation of health information systems. Peer support and telemedicine were the only two potential solutions identified. Conclusions This study offers a comprehensive evaluation of integrated care for hypertension and type 2 diabetes in Slovenia, featuring insights into facilitators and barriers. These findings have implications for policy and practice. Monitoring integrated care progress, refining strategies, and enhancing care quality for patients with these two diseases should be priorities in Slovenia.

Publisher

Walter de Gruyter GmbH

Subject

Public Health, Environmental and Occupational Health

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