<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>Introduction</h3>
<p>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.</p>
</sec>
<sec>
<h3>Methods</h3>
<p>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.</p>
</sec>
<sec>
<h3>Results</h3>
<p>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 Some of identified barriers were political inertia and underutilisation of research findings in practice; outdated health financing system; accessibility challenges, especially for vulnerable populations; healthcare workforce knowledge and burnout; patients’ complex role in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.</p>
</sec>
<sec>
<h3>Conclusions</h3>
<p>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.</p>
</sec>
</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.

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

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

PRILOŽNOSTI IN OVIRE ZA IZBOLJŠANJE CELOSTNE OSKRBE ARTERIJSKE HIPERTENZIJE IN SLADKORNE BOLEZNI TIPA 2 V SLOVENIJI: KVALITATIVNA ŠTUDIJA

Introduction
Arterial hypertension and type 2 diabetes are significant contributors to global non-communicable disease-related mortality. Integrated care,...

Characteristic	N	%
Gender
male	4	8.3
female	44	91.7
Workplace location
urban	26	54.2
rural	22	45.8
Profession
general practitioner	11	22.9
practice nurse	1	2.1
advanced nurses	20	41.7
prevention nurse	6	12.5
community nurse	10	20.8

Participants level	Participant
Meso
	Community Health Centre Ljubljana (3 interviews)
	and Postojna
	Institution for informal home care
	Municipality of Ljubljana (2 interviews)
	Associations of patients with chronic diseases (2 interviews)
	Associations of patients with chronic diseases
	Nursing home
Macro
	The National Institute of Public Health (2 interviews)
	The Health Insurance Institute of Slovenia
	Ministry of Health (2 interviews)
	Chamber of Pharmacies of Slovenia
	Health Council at Ministry of Health
	Nurses and Midwives Association of Slovenia
	Medical Faculty of Ljubljana, Department of Family medicine (3 interviews)
	Medical Chamber of Slovenia

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

Article Category: Original scientific article

Publicado en línea: 03 ene 2024

Páginas: 38 - 45

Recibido: 31 oct 2023

Aceptado: 27 nov 2023

DOI: https://doi.org/10.2478/sjph-2024-0006

Palabras clave
Integrated care, Hypertension, Type 2 diabetes, Barriers, Facilitators

© 2024 Črt ZAVRNIK et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Participants in the focus group discussions with patients.

Participants in the interviews.

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

Article Category: Original scientific article

Publicado en línea: 03 ene 2024

Páginas: 38 - 45

Recibido: 31 oct 2023

Aceptado: 27 nov 2023

DOI: https://doi.org/10.2478/sjph-2024-0006

Palabras claveIntegrated care, Hypertension, Type 2 diabetes, Barriers, Facilitators

© 2024 Črt ZAVRNIK et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Participants in the focus group discussions with patients.

Participants in the interviews.

Palabras clave
Integrated care, Hypertension, Type 2 diabetes, Barriers, Facilitators