AB1399 PEOPLE SUFFERING FROM RHEUMATIC AND MUSCULOSKELETAL DISEASES DESCRIBE THEIR OWN EXPERIENCES OF INTEGRATED CARE: FINDINGS FROM A CROSS‑SECTIONAL STUDY AMONG ITALIAN PATIENTS

Abstract

BackgroundIntegrated care is an approach to health care based on multidisciplinary working and the continuity and coordination of different levels of care (1). In an integrated care setting, health services are designed to go beyond fragmentation and isolation and delivered in response to chronic patient health needs. Integrated care has been proved to enhance patients’ quality of life (2), as well as reduce hospital admission rates and length of stay (3). Furthermore, integrated care favors patients’ access to care and improves their satisfaction (4). To evaluate the application and benefits of integrated care, patient experiences should be measured (5). However, while the patient experiences of integrated care have been documented for various chronic diseases, little is known in the context of rheumatic and musculoskeletal diseases (RMDs).ObjectivesThis study aims at providing an overview of the patient experience of integrated care of RMDs patients in Italy and defining the experience profiles and priorities of different patient subgroups.MethodsA cross-sectional online self-administered survey formulated following a scoping review of the literature was administered to a purposive sample of Italian RMDs patients (n=433). Respondents were asked to evaluate their patient experience and the importance attributed to different aspects of integrated care. Explorative factor analysis (EFA) was performed to determine the dimensions of integrated care investigated by the survey. The differences in the responses provided by different subgroups of the sample were assessed using the non-parametric versions of ANOVA and ANCOVA statistical tests with Scheffe’s adjustment for multiple comparisons.ResultsTwo factors (“person-centered care” and “health service delivery”) were extracted in the EFA. Respondents attributed high importance to both of them. However, an overall positive experience was reported only for the dimension of person-centered care. The delivery of integrated care services was evaluated poorly, especially for digital ones. Women described both dimensions of integrated care as more important compared to men (H(1)=45.292, p<.001 and H(1)=6.998, p=.008). However, their experience of integrated care services was significantly worse (H(1)=20.201, p<.001). Older participants reported poorer health service delivery compared to younger ones (H(3)=73.203, p=.009), especially for digital and outpatient services. Person-centered care was especially important for patients with comorbidities (F(1,431)=4.944, p=.027). However, this subgroup reported markedly worse experiences of integrated care services (F=(1,431)=4.187, p=.041).ConclusionItalian RMDs patients identified integrated care as something important to them. They reported receiving positive person-centered care but the delivery of integrated care services was evaluated poorly. Different patient subgroups described different experience profiles and priorities. This diversification can inform the design of tailored interventions to address the specific concerns and needs of each patient subgroup.