Person-Centred and Integrated Care: Understanding Barriers and Facilitators in the Dutch Context for the Care of Patients with Chronic Diseases and Multimorbidity

Abstract

Person-Centred Integrated Care (PC-IC) has emerged as a promising approach to improve care for patients with multimorbidity. However, its implementation in primary care settings remains challenging. This study aimed to identify and analyse the barriers and facilitators to PC-IC implementation in Dutch primary care practices. A thematic analysis was conducted with eight semi-structured interviews with healthcare providers of care groups in the Netherlands and secondary data from a previous study by Verhoeven (2023). A fieldwork case study at a healthcare organisation was conducted to enrich the data. The analysis revealed a complex, interconnected network of factors, including healthcare professional competencies, organisational culture, financing structures, and a paradox between standardisation and customisation of care. Key barriers included time constraints, workload, various digital communication systems, registration protocols and funding structures. Key facilitators included a shared vision of PC-IC, adequate skills and experience of healthcare professionals, familiarity with other professionals and motivation. This study provides valuable insights for policymakers and care groups seeking to implement PC-IC in primary care settings. Future research should focus on developing and evaluating targeted interventions to address the identified barriers and leverage facilitators for successful PC-IC implementation. The study revealed the interconnected nature of these factors, highlighting the need for a systemic approach to PC-IC implementation. The study proposes recommendations from participants to improve communication platforms, adapt registration protocols and use digital tools with patients. This research contributes to the broader discourse on improving healthcare delivery for multiple chronic diseases. Keywords: multimorbidity; integrated care; person-centred care; primary care; care groups; health policy; nurse practitioner