Who Wants To Improve Collaboration in Services for Individuals with Chronic Conditions? Specialists and Rural General Practitioners Taking Action in a Fragmented Health Care System

Abstract

Introduction Strategies to improve fragmented care for individuals with chronic conditions can be futile if those health care professionals who would have benefited are not engaged. We aimed to explore motivation and previous collaboration quality of general practitioners (GPs) and specialists who participate in an intervention study to improve their collaboration, and GPs who do not participate. Methods Explorative survey among rural GPs and specialists for spinal cord injury (SCI) participating in an intervention to improve collaboration, and non-participating GPs, from August to October 2020, in Switzerland. Results Eight GPs and 13 specialists of the intervention study and 23 non-participating GPs took part. Specialists were from various medical disciplines. Participating GPs were located farther away from a hospital and consulted a higher number of patients. Overall, the collaboration quality at the primary-secondary care interface was good. Whereas specialists and participating GPs were mostly satisfied with their collaboration, non-participating GPs’ reported a lower quality regarding some aspects of collaboration. Furthermore, differences in collaboration quality between general chronic care and SCI specific care could be observed. Conclusion The collaboration quality was rather high in participating physicians. The benefit of the intervention would have been higher in non-participating than participating GPs. When participation is optional, interventions to improve collaboration likely do not achieve the effect that would actually be possible.