The ongoing SARS-CoV-2 pandemic is posing colossal pressure on all health systems worldwide. Given the epidemiological features of the virus, the authors aimed at analyzing how the most vulnerable and highly fragmented sector in Ticino reacted from an organizational point of view to a large-scale public health emergency. The present in-depth analysis shed light on two critical aspects: the tardive prioritization of specific strategies aimed at minimizing the risk of infections and, more generally, the lack of coordination between the stakeholders involved. During the first phase of the pandemic outbreak, the priority of the competent authorities was mainly focused to determine the infected people and major efforts were established in strengthening hospital intensive care units. This, however, has placed the elderly and homecare sector in a hazardous position, posing significant inter-and intra-organizational challenges in responding effectively to the unprecedented health emergency.
Background
The increase in demand for long-term care is associated with the need for cost containment. A transition towards the Integrated Community Care (ICC) approach should lead to cost containment and greater user satisfaction. The Swiss government has repeatedly raised the issue of the integration of care, but Switzerland seems to lag behind in the implementation of this care models.
Methods
We conducted a series of case studies on the Italian-speaking area of Switzerland with the aim of exploring the reason of network formation. Data was collected using semi-structured interviews. The case studies include six public home care services and twenty nursing homes. The collected data was analysed using ATLAS.ti through content analysis carried out using the Preparation-Exploration-Specification-Interpretation approach.
Results
The reasons why ICC models are struggling to develop in Switzerland are: i) the caring system is anchored to a broader municipality-based proximity system; ii) the system is historically based on subsidiarity and public-private co-existence; iii) the system is a resource-intensive that is late in perceiving the need to optimise resources; iv) the system based is on a high reliance on formal services; v) the system based on consensus and stability that struggles with the need for rapid intervention.
Conclusions
The implementation of innovative models of taking care of the elderly is strongly influenced by the institutional context. Policymakers to increase the effectiveness of their interventions are called to eliminate possible institutional barriers.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.