Adaptations d’une matrice de maturité des soins intégrés pour des prestataires de soins et des cantons suisses

Mathy, Caryn and Majo, Jocelyne and Bosisio, Francesca and Carron, Tania and Campisi, David and Peytremann-Bridevaux, Isabelle and Wampler, Audrey (2025): Adaptations d’une matrice de maturité des soins intégrés pour des prestataires de soins et des cantons suisses.

Abstract

Context: The performance of integrated care systems lacks evidence, partly due to the difficulty in conducting robust studies. This generates uncertainty among both providers and decision-makers. However, an evaluation tool has been developed under the auspices of the European Commission. It is a maturity matrix called “Scaling Integrated Care in Context” (SCIROCCO), developed from a macro perspective. Objective: The project aimed to adapt SCIROCCO for healthcare providers, specifically the three health poles in Vaud, on one hand, and for the Canton of Vaud, on the other hand, requiring the adoption of two distinct meso-level perspectives. Method: Seven researchers worked on structuring and rewriting each element of SCIROCCO in successive individual and collective phases, seeking consensus. This work was then reviewed by five professionals before being disseminated to users. Results: Two maturity matrices were created: one for the health poles (SCIROCCO-POLE) and one for the canton (SCIROCCO-CANTON), retaining the original dimensions but contextualizing them differently. The response scale still has six levels, but it was standardized to remain consistent regardless of the health organization or evaluated dimension. Conclusion: Adapting SCIROCCO to other healthcare organizations appears feasible, although it requires substantial effort. Nevertheless, it provides a pragmatic diagnostic and management response for stakeholders. Further work is desirable to enhance the tool and incorporate an additional dimension—the collaboration between actors.

• Item Type: MPRA Paper
• English Title: Integrated care maturity matrix adaptations for healthcare providers and Swiss cantons
• Language: French
• Keywords: Institutions de santé; Organisation des soins; Soins intégrés; Performance; Matrice de maturité
• Subjects: D - Microeconomics > D2 - Production and Organizations > D24 - Production ; Cost ; Capital ; Capital, Total Factor, and Multifactor Productivity ; Capacity; H - Public Economics > H1 - Structure and Scope of Government > H11 - Structure, Scope, and Performance of Government; I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets; M - Business Administration and Business Economics ; Marketing ; Accounting ; Personnel Economics > M1 - Business Administration > M10 - General; O - Economic Development, Innovation, Technological Change, and Growth > O2 - Development Planning and Policy > O22 - Project Analysis

References

[1] OCDE/Union européenne. (2022). Health at a Glance : Europe 2022 : State of Health in the EU Cycle. Paris : Organisation de coopération et de développement économique OCDE. https://doi.org/10.1787/507433b0-en

[2] Secrétariat général DFI. (2022). Assurance-maladie : la forte augmentation des coûts entraîne une hausse des primes en 2023. Le Conseil fédéral : le portail du Gouvernement suisse. Consulté le 20 février 2024 sur https://www.admin.ch/gov/fr/accueil/documentation/communiques.msg-id-90514.html

[3] Département fédéral de l’intérieur. (2023). La forte augmentation des coûts entraîne une nette hausse des primes en 2024. Le Conseil fédéral : le portail du Gouvernement suisse. Consulté le 20 février 2024 sur https://www.admin.ch/gov/fr/accueil/documentation/communiques.msg-id-97889.html

[4] de Mestral C., Petrovic D., Marcus K., Dubos R., Guessous I., Stringhini S. (2022). Renoncement aux soins de santé en Suisse : prévalence, déterminants et conséquences. Berne : Office fédéral de la santé publique OFSP. https://www.aramis.admin.ch/Default?DocumentID=69027&Load=true

[5] OCDE. (2010.) Améliorer le rapport coût-efficacité des systèmes de santé. Note de politique économique n°2. OCDE Département des Affaires Économiques

[6] OCDE. (2023). Health at a Glance 2023: OECD Indicators. Paris : OCDE Publishing. https://doi.org/10.1787/7a7afb35-en

[7] Paris, V. (2012). Les performances comparées des systèmes de santé. Les Tribunes de la santé, 35(2), 43-49. https://doi.org/10.3917/seve.035.0043

[8] OCDE. (2024). Repenser l’évaluation de la performance des systèmes de santé : un cadre renouvelé. Paris : OCDE Publishing. https://doi.org/10.1787/04e8cdb9-fr

[9] OFSP. (2019). Politique de la santé : stratégie du Conseil fédéral 2020-2030. Berne : Office fédéral de la santé publique OFSP. https://www.bag.admin.ch/dam/bag/fr/dokumente/nat-gesundheitsstrategien/gesundheit-2030/strategie-gesundheit2030.pdf.download.pdf/strategie-sante-2030.pdf

[10] Vincent C., Staines A. (2019). Améliorer la qualité et la sécurité du système de santé suisse. Berne : Office fédéral de la santé publique OFSP. https://www.newsd.admin.ch/newsd/message/attachments/59014.pdf

[11] Berchtold P., Schusselé Filliettaz S., Zanoni U. (2019). Nouvel élan pour les soins intégrés dans les cantons : un guide. Berne : Conférence suisse des directrices et directeurs cantonaux de la santé CDS. https://www.gdkcds. ch/fileadmin/docs/public/gdk/themen/integrierte_versorgung/GDK_Leitfaden_FR_def.pdf

[12] OMS. (2016). Cadre pour des services de santé intégrés centrés sur la personne : rapport du Secrétariat. Genève : OMS. https://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_39-fr.pdf

[13] Nolte E., Pitchforth E. (2014). What is the evidence on the economic impacts of integrated care? [S.l] : World Health Organization. Regional Office for Europe. https://iris.who.int/handle/10665/332002

[14] Bautista M.A.C., Nurjono M., Lim Y.W., Dessers E., Vrijhoef H.J. (2016) Instruments Measuring Integrated Care : A Systematic Review of Measurement Properties. The Milbank Quarterly, 94(4), 862 917. https://doi.org/10.1111/1468-0009.12233

[15] Grooten L., Borgermans L., Vrijhoef H.J.M. (2018) An Instrument to Measure Maturity of Integrated Care: A First Validation Study. International Journal of Integrated Care, 18(1), 10. https://doi.org/10.5334/ijic.3063

[16] Hughes G., Shaw S.E., Greenhalgh T. (2020). Rethinking Integrated Care: A Systematic Hermeneutic Review of the Literature on Integrated Care Strategies and Concepts. The Milbank Quarterly, 98, 446-492. https://doi.org/10.1111/1468-0009.12459

[17] Nuño Solinís R., Stein K.V. (2016). Measuring Integrated Care – The Quest for Disentangling a Gordian Knot. International Journal of Integrated Care, 16(3), 18. https://doi.org/10.5334/ijic.2525

[18] Rocks S., Berntson D., Gil-Salmerón A., Kadu M., Ehrenberg N., Stein V., et al. (2020). Cost and effects of integrated care: a systematic literature review and meta-analysis. The European Journal of Health Economics, 21, 1211-1221. https://doi.org/10.1007/s10198-020-01217-5

[19] Schusselé Filliettaz S., Berchtold P., Kohler D., Peytremann-Bridevaux I. (2018). Integrated care in Switzerland: Results from the first nationwide survey. Health Policy, 122(6), 568–76. https://doi.org/10.1016/j.healthpol.2018.03.006

[20] Kodner D.L. (2009). All together now: a conceptual exploration of integrated care. Healthcare Quarterly, 13(Sp), 6 15. https://doi.org/ 10.12927/hcq.2009.21091

[21] Monod S., Pin S., Levy M., Grandchamp C., Mariétan X., Courvoisier N. (2024). Analyse de la gouvernance du système de santé suisse et proposition d’une loi fédérale sur la santé. Lausanne : Centre universitaire de médecine générale et santé publique. https://doi.org/10.16908/issn.1660-7104/354

[22] Whitehouse D., Lange M., Henderson D., Pavlickova A. (2019). SCIROCCO : D2.3 Layman version of the final report ; WP2 Dissemination and Exploitation. [S.l.] : European Union. https://scirocco-project.eu/wp-content/uploads/2019/10/D2.3-Layman-version-of-final-report-Final-V1.1.pdf

[23] Peytremann-Bridevaux I., Schusselé Filliettaz S., Berchtold P., Grossglauser M., Pavlickova A., Gilles I. (2021). Healthcare system maturity for integrated care: results of a Swiss nationwide survey using the SCIROCCO tool. BMJ Open, 11(e041956). https://doi.org/10.1136/bmjopen-2020-041956

[24] McBride T. (2010). Organisational theory perspective on process capability measurement scales. Journal of Software Maintenance and Evolution: Research and Practice, 22, 243–54. https://doi.org/10.1002/spip.440

[25] Wendler R. (2012). The maturity of maturity model research: A systematic mapping study. Information and Software Technology, 54(12), 1317–39. https://doi.org/10.1016/j.infsof.2012.07.007

[26] HAS. (2012). Matrices de maturité en soins primaires : note de synthèse. Saint-Denis La Plaine-France : HAS. https://www.has-sante.fr/upload/docs/application/pdf/2013-03/matrices_de_maturite_en_soins_primaires_note_de_synthese.pdf

[27] HAS. (2018). Matrice de maturité en soins primaires Pacte : guide d’utilisation. Saint-Denis La Plaine-France : HAS. https://www.has-sante.fr/upload/docs/application/pdf/2014-10/matrice_de_maturite_-_guide_utilisation.pdf

[28] DGOS. (2016). PHARE : performance hospitalière pour des achats responsables - méthodologie d’élaboration d’un Plan d’Actions Achat de Territoire (PAAT) - kit de déploiement. [S.l.] : DGOS. https://sante.gouv.fr/IMG/pdf/dgos_phare_paat_kit_appui.pdf

[29] Blondiau A., Mettler T., Winter R. (2016). Designing and implementing maturity models in hospitals: An experience report from 5 years of research. Health Informatics Journal;22(3):758-767. https://doi.org/10.1177/1460458215590249

[30] Henderson D.H., Pavlickova A., Lewis L. (2016). Scalability and transferability of good practices in Europe: What does it take? International Journal of Integrated Care, 16(6), A191 https://doi.org/10.5334/ijic.2739.

[31] Grooten L., Vrijhoef H.J.M., Calciolari S., Ortiz L.G.G., Janečková M., Minkman M.M.N., et al. (2016). Assessing the maturity of the healthcare system for integrated care: testing measurement properties of the SCIROCCO tool. BMC Medical Research Methodology, 19(63). https://doi.org/10.1186/s12874-019-0704-1

[32] Grooten L., Alexandru C.-A., Alhambra-Borrás T., Anderson S., Avolio F., Valia Cotanda E., et al. (2019). A scaling-up strategy supporting the expansion of integrated care: a study protocol. Journal of Integrated Care, 27, 215-231. https://doi.org/10.1108/JICA-04-2018-0029

[33] Mathy C., Bosisio F., Majo J., Campisi D., Wampler A. (2024) SCIROCCO-POLE et SCIROCCO-CANTON. Guide d'utilisation de deux matrices d'évaluation du degré de maturité des soins intégrés. Version 1. Yverdon-les-Bains : Haute école d'ingénierie et de gestion du canton de Vaud, HES-SO. https://doi.org/10.5281/zenodo.10817836