Abstract
Background: Chronic Wounds (CWs) present a significant healthcare challenge worldwide, impacting patients' quality of life through prolonged healing, psychological stress, and daily disruptions. Addressing CWs with effective care strategies and preventive measures is critical, not only for economic reasons but to enhance the well-being of millions affected. Integrated Care (IC), a patient-centred approach that combines health and social care, has shown effectiveness in managing CWs by providing safe, timely, and efficient care, thereby improving the clinical outcomes and quality of life of the patients. Assessing the maturity of IC in CW management is essential for developing sustainable solutions. The SCIROCCO online assessment tool , which evaluates 12 key dimensions of IC maturity, offers a structured method to gauge a region's readiness for implementing IC. This study aimed to assess IC maturity in the healthcare systems of Ireland, Poland, and Spain by combining the top-down expertise of knowledge partners with bottom-up input from local healthcare providers and stakeholders using the SCIROCCO tool. The goal is to understand perspectives, needs, and expectations regarding IC for CW management.
Approach: Between August and September 2024, key stakeholders*, including the healthcare managers and providers, patients and Patients’ organizations, Clinical Scientists and researchers and the policymakers, in each country completed the SCIROCCO online assessment. The Assessment the evaluates the maturity of IC across 12 dimensions. Each dimension includes a description of objectives followed by a six-point scale, from 0 ("not fulfilled") to 5 ("fully fulfilled"), allowing for a detailed evaluation of IC readiness.
Results: Spain, Poland, and Ireland display varying degrees of the maturity of IC across the 12 dimensions. Findings highlight the need to strengthen primary and community care for CW management. Spain demonstrates progress in digital infrastructure and chronic disease management but faces regional governance disparities. Poland is at a foundational stage of digital infrastructure, with limited strategic planning and funding. Ireland shows a proactive approach with ongoing programs like Sláintecare, indicating a commitment to reform. but struggles with slow implementation and fragmented digital systems.
Implications: The SCIROCCO assessment provides a valuable foundation for refining the IC model, especially for CW management, and reveals distinct challenges in each country. Spain, Poland, and Ireland show different stages of progress in IC but face common barriers in funding, evaluation, and capacity building. Addressing specific structural barriers and fostering strategic planning, stakeholder engagement, and resource allocation are essential for advancing IC systems across these regions.
* Lists of eligible participants were identified during the workshop for Stakeholder engagement conducted in July 2024, and the identified stakeholders formed the core group targeted for this assessment.