Abstract
Background: Integrated care is a proven intervention for enhancing health system performance and quality and accessibility [1]. However, implementing integrated care is context-dependent, requiring an assessment of healthcare systems’ readiness [2]. In Portugal, recent reforms toward vertical integration in healthcare highlights the need for such assessments[3]. The SCIROCCO tool offers a structured method to evaluate health systems’ maturity- defined as the system’s capacity to provide integrated care services [4]. This tool identifies strengths and areas needing improvement, offering policymakers insights to support system sustainability and improving health outcomes [5].
Approach: This cross-sectional study uses the SCIROCCO questionnaire to evaluate the maturity of Local Health Units (LHUs) in Portugal for integrated care provision. The SCIROCCO questionnaire assesses essential dimensions of readiness for integrated care, highlighting current strengths and weaknesses of different regions [6]. A pilot phase was conducted in one LHU to assess feasibility and response rates of the questionnaire between September 2024 and November 2024.
Results and Implications: The questionnaire was sent via email to 1187 participants, with an approximate response rate of 3%. This low response rate aligns with similar studies using remote survey methods with healthcare professionals, suggesting potential biases and raising concerns about the study’s validity [7, 8].
The findings underscore the need to reevaluate recruitment strategies that rely on similar methodologies. Techniques such as personalized invitations, direct explanations of the study’s relevance, and diversified recruitment strategies (e.g. in-person distribution at team meetings) are suggested to enhance engagement. Communicating study findings and demonstrating how participants’ contributions are used may also foster a sense of involvement and purpose, thereby encouraging future engagement [8, 9]. Addressing these challenges will improve response rates, enhance the reliability of findings, and support informed policymaking in integrated care.