Isabelle Peytremann-Bridevaux

Unisante · Epidemiology and Health Systems

With the COVID-19 pandemic, the notion of health system (HS) performance has been discussed, and the notion of resilience has become increasingly important. Lacking a recognised framework that measures the performance of HSs throughout a crisis, i.e., one that explicitly includes time as a key aspect, we examined the literature about conceptual fra...

Rationale, aimsand objectives: Healthcare systems are confronted with a rising number of patients with chronic conditions and complex care needs, requiring the development of new models of coordinated, patient-centred care. In this study, we aimed to describe and compare a range of new models of care recently implemented in primary care in Switzer...

Purpose Cancer care is undergoing a conceptual shift with the introduction of the principles of patient-centered care to support patients’ individual needs. These needs include those related to hospitality during cancer treatments. This paper aims to provide an extension of the supportive care framework by bringing in the hospitality approach inspi...

Implementing innovations in care delivery in Switzerland is challenging due to the fragmented nature of the system and the specificities of the political process (i.e., direct democracy, decentralized decision-making). In this context, it is particularly important to account for population preferences when designing policies. We designed a discrete...

Background Diabetes represents a major health burden both at the individual and societal levels. Physical activity is always recommended to reduce the incidence of diabetes and its complications, but its effects on self-reported health are lacking. This study aimed to explore how physical activity and sedentary behaviors were associated with self-r...

Introduction: Increasing life expectancy raises concerns whether the years gained will be spent free of disability. Lately, trends across countries have been heterogeneous. This work examined recent trends in disability-free life expectancy and life expectancy with mild or severe disability in Switzerland. Methods: Life expectancy was estimated...

Background Population ageing puts pressure on health systems initially designed to handle acute and episodic illnesses. Segmenting an ageing population based on its healthcare utilization may enable policymakers to undertake evidence-based resource planning. We aimed to derive a typology of healthcare utilization trajectories in Swiss older adults....

Objectives: The objectives were to describe patients' experiences of cancer care in Switzerland and explore the variation of these experiences by type of cancer. Methods: The Swiss Cancer Patient Experiences (SCAPE) study was a cross-sectional, multicentre survey conducted in 2018. Adult patients (n = 7145) with breast, prostate, lung, colorecta...

Background Self-management can improve health status and reduce hospitals admissions in patients with chronic obstructive pulmonary disease (COPD). The aim of this mixed-methods study was to evaluate the implementation of the ‘Living well with COPD’ self-management program, a nation-wide effort by the Swiss Lung Associations and the Swiss society o...

Objective To describe how longitudinal continuity of care (COC) is measured using claims-based data and to review its association with healthcare use and costs. Research design Rapid review of the literature. Methods We searched Medline (PubMed), EMBASE and Cochrane Central, manually checked the references of included studies, and hand-searched w...

Background: High-quality cancer care should be effective, safe, accessible, efficient, equitable, and responsive to patients’ needs. In Switzerland, information on the safety and effectiveness of cancer care is available, but not on responsiveness. Systematic and comprehensive reports from patients on cancer care are missing and needed to complete...

Background Despite the growing burden of diabetes worldwide, evidence regarding the optimal models of care to improve the quality of diabetes care remains equivocal. This study aimed to identify profiles of patients with distinct ambulatory care use patterns and to examine the association of these profiles with the quality of diabetes care. Method...

Objectives To quantitatively assess the early impact of the COVID-19 pandemic on in-person outpatient care utilisation worldwide, as well as across categories of services, types of care and medical specialties. Design Rapid review. Method A search of MEDLINE and Embase was conducted to identify studies published from 1 January 2020 to 12 February...

Objective to assess the relationship between continuity of care (COC) and multimorbidity in the older general population in Switzerland, accounting for relevant determinants of COC, and to apply various expressions of multimorbidity derived from claims data. Methods We used data on 240′000 insured individuals aged 50+ for the period 2015–2018, rec...

Background Continuity of care (COC) should be measured for healthcare quality monitoring and evaluation and is a key process indicator for integrated care. Measurement of COC using routinely collected data is widespread, but there is no consensus on which indicator to use and the relevant time horizon to apply. Information about COC is especially w...

Rationale, aims and objectives: The Patient Assessment of Chronic Illness Care (PACIC) instrument assesses patient care in alignment with the chronic care model. The aim of the study was to comprehensively validate the PACIC using the Rasch model. A special focus was placed on the investigation of local dependence (LD), differential item functioni...

Background Most claims-based frailty instruments have been designed for group stratification of older populations according to the risk of adverse health outcomes and not frailty itself. We aimed to develop and validate a tool based on one-year hospital discharge data for stratification on Fried's frailty phenotype (FP). Methods We used a three-st...

Objectives: Women are underrepresented in most HIV clinical trials in Western countries, but their participation remains crucial as the lack of information on sex- and gender-specific effects may hinder the safety and efficacy of antiretroviral treatments. The aim of this study was to identify barriers to and facilitators of women's participation...

Objective: Our objective was to develop and test a discrete choice experiment (DCE) eliciting public and patient preferences for better-coordinated care in Switzerland. Methods: We applied a multistage mixed-methods procedure using qualitative and quantitative approaches. First, to identify attributes, we performed a review of the DCE literature...

Objectives: To explore how perceived disease threat and trust in institutions relate to vaccination intent, perceived effectiveness of official recommendations, and to othering strategies. Methods: We conducted a cross-sectional survey of Swiss adults in July 2020. Outcome variables were vaccination intent, perceived effectiveness of official recom...

Introduction: Switzerland's fragmented healthcare system mirrors its federal structure and mix of cultures and languages. Although the Swiss have a higher life expectancy than most of their neighbours, their healthcare system faces similar challenges that call for more integrated care (IC). Aim/method: This article aims to provide insight into t...

In 2016, in Switzerland, we implemented transitional interprofessional and interinstitutional shared decision-making processes (IIPs) between a short-stay inpatient care unit (SSU) and primary care professionals. Between 2018 and 2019, we evaluated this intervention using a realist design to answer the following questions: for whom, with whom, in w...

Background: Although the trend of progressing morbidity is widely recognized, there are numerous challenges when studying multimorbidity and patient complexity. For multimorbid or complex patients, prone to fragmented care and high health care use, novel estimation approaches need to be developed. Objective: This study aims to investigate the pa...

BACKGROUND Although the trend of progressing morbidity is widely recognized, there are numerous challenges when studying multimorbidity and patient complexity. For multimorbid or complex patients, prone to fragmented care and high health care use, novel estimation approaches need to be developed. OBJECTIVE This study aims to investigate the patien...

Our study aimed at investigating the way not having the choice to be reassigned was associated to a poorer experience of reassignment among health care workers (HCWs) during the first wave of the coronavirus disease 2019 (COVID-19), and indirectly to a lower workplace well-being and reduced intent to stay at the hospital. We also investigated the m...

Health system resilience, known as the ability for health systems to absorb, adapt or transform to maintain essential functions when stressed or shocked, has quickly gained popularity following shocks like COVID-19. The concept is relatively new in health policy and systems research and the existing research remains mostly theoretical. Research to...

Health system resilience, known as the ability for health systems to absorb, adapt or transform to maintain essential functions when stressed or shocked, has quickly gained popularity following shocks like COVID-19. The concept is relatively new in health policy and systems research and the existing research remains mostly theoretical. Research to...

Background: Recent advances made in cell and gene therapies for cancer suggest that they represent plausible strategies to cure HIV. However, the health risks and constraints associated with these therapies require a deeper understanding of the expectations of such treatments among people living with HIV (PLWH). Methods: We conducted 15 semistructu...

Objective We aimed to identify the main barriers to integrated care (IC) as reported by healthcare stakeholders from various linguistic regions and health system specificities, according to their reality of practice. Methods Information was gathered through an open-ended question from a national survey conducted in Switzerland in 2019. Responses w...

Introduction: Interprofessional collaboration (IPC) is increasingly used but diversely implemented in primary care. We aimed to assess the effectiveness of IPC in primary care settings. Methods: An overview (review of systematic reviews) was carried out. We searched nine databases and employed a double selection and data extraction method. Patie...

Introduction: Interprofessional collaboration (IPC) is becoming more widespread in primary care due to the increasing complex needs of patients. However, its implementation can be challenging. We aimed to identify barriers and facilitators of IPC in primary care settings. Methods: An overview of reviews was carried out. Nine databases were searc...

Objective To evaluate the nationwide implementation of the “Living well with COPD” program by the Swiss Lung Association in various cantons in Switzerland. Methods For the process evaluation, we used qualitative (interview, focus group) and quantitative (questionnaires, documentation analysis) methods to assess the implementation outcomes reach, d...

Introduction Shared decision‐making (SDM) processes, combining patients' and professionals' perspectives, are especially necessary for patients with complex needs (CNs) during their care transitions. In 2016, we started implementing interprofessional and interinstitutional SDM processes (IIPs) for patients admitted to a short‐stay unit (SSU) for in...

Objective: To identify and describe the factors influencing adult diabetes self-management by summarizing the available evidence concerning their types, categories, and relative importance. Introduction: Diabetes self-management is influenced by a wide range of factors acting simultaneously and interfering with its actual application by patients...

During the first wave of Covid-19, hospital professionals had to quickly adapt their practices and introduce several changes in the organization of work and patient care. In this study, we were interested in how these changes were experienced by the professionals of 11 hospitals in French-speaking Switzerland. The results underline the importance o...

Background Diabetes is one of the most important chronic diseases and affects 9% of the world’s population. To support these people in the day-to-day management of their treatments, pharmacies can offer professional pharmacy services. These are defined as one or more actions organized or provided in a pharmacy to optimize the process of care, with...

Ce bulletin présente en premier lieu les tendances récentes observées en Suisse quant à la fréquence des incapacités fonctionnelles dans la population âgée, ainsi que l’évolution récente de l’espérance de vie à l’âge de 65 ans en Suisse, avec et sans incapacités fonctionnelles. Ces données suisses sont complétées par un état des connaissances dans...

Objectives To assess the maturity of the Swiss healthcare system for integrated care and to explore whether this maturity varied according to several variables. Design A Swiss nationwide individual electronic survey in November 2019. Setting and population Stakeholders identified via lists of the Swiss Forum for Integrated Care and of the integra...

The present study describes adult diabetes self-management (DSM) profiles using self-reported outcomes associated with the engagement in diabetes care activities and psychological adjustment to the disease. We used self-reported data from a community-based cohort of adults with diabetes (N = 316) and conducted a cluster analysis of selected self-re...

Background Most claims-based frailty instruments have been designed for group stratification of older populations according to the risk of adverse health outcomes and not frailty itself. We aimed to develop and validate a tool based on one-year hospital discharge data for stratification on Fried's frailty phenotype (FP). Methods We used a three-sta...

Introduction Continuity of care, especially for patients with complex needs, is a major challenge for healthcare systems in many high-income countries, including Switzerland. Since 2015, a collaborative project between Unisanté-Department of Family Medicine (DMF), some general practitioners (GPs) and canton of Vaud’s public health authorities has s...

Background Patient experience surveys are increasingly conducted in cancer care as they provide important results to consider in future development of cancer care and health policymaking. These surveys usually include closed-ended questions (patient-reported experience measures (PREMs)) and space for free-text comments, but published results are mo...

Introduction: Interprofessional collaboration (IPC) is a key ingredient of integrated care. Nevertheless, IPC benefits remain unclear and its implementation within integrated care initiatives is not straightforward. In this study, we first explored whether IPC was associated with organisational and patient care improvements in Swiss integrated car...

Background: Transplant recipients are chronically ill patients, who require lifelong follow-up to manage co-morbidities and prevent graft loss. This necessitates a system of care that is congruent with the Chronic Care Model. The eleven-item self-report Patient Assessment of Chronic Illness Care (PACIC) scale assesses whether chronic care is congr...

Background: The association between patient satisfaction and survey response is only partly understood. In this study, we describe the association between average satisfaction and survey response rate across hospital surveys, and model the association between satisfaction and propensity to respond for individual patients. Methods: Secondary anal...

Introduction La Suisse et la France ne contribuent pas aux comparaisons internationales de l’OCDE sur la sécurité des arthroplasties de hanche (PTH) et de genou (PTG) utilisant les taux standardisés de thromboses veineuses profondes (TVP) ou d’embolies pulmonaires (EP) à 30 jours. L’objectif principal de cette étude était d’estimer et de comparer l...

Introduction: For more than two decades, integrated care initiatives have been considered and implemented throughout Europe and North America to overcome challenges linked to chronic disease care in communities [1, 2]. These initiatives aim at reorganizing healthcare systems and services to foster care continuity, coordination and integration. Amon...

Aims: We aimed to assess the health status and quality of life (QoL) of patients with diabetes and explore the associated factors in a French-speaking region of Switzerland. Methods: This cross-sectional study analyzed self-reported data from 585 patients with diabetes. We ran univariate and multivariate regressions analyses on health status (Ph...

Purpose: The Patient Assessment of Chronic Illness Care (PACIC) was created to assess whether provided care is congruent with the Chronic Care Model, according to patients. We aimed to identify all studies using the PACIC in diabetic patients to explore (i) how overall PACIC scores varied across studies and (ii) whether scores varied according to...

Introduction: Due to fragmentation of care delivery, health systems are under pressure and integrated care is advocated for. Compared to the numerous existing integrated care initiatives in Europe and elsewhere, Switzerland seems to lag behind. Methods: The objective of the survey was to produce a comprehensive overview of integrated care initia...

Question under study: The aim of this study was to assess the feasibility, acceptability and effectiveness of a pilot COPD integrated care programme implemented in Valais, Switzerland. Methods: The programme was adapted from the self-management programme Living Well with COPD, and included the following elements: self-management patient-educatio...

Objective: The association between diabetes and depression, a common health comorbidity in people with diabetes, has been recognized but not well understood. The purpose of this study was to explore the association between diabetes and depression in a large international sample of adults, adjusting for demographics, socioeconomic status, behaviora...

Review objectives: The aim of this umbrella review is to identify and describe factors influencing diabetes self-management (DSM) in adults with diabetes. More specifically, we will address DSM-related factors and their relationships, considering both qualitative and quantitative components of available literature.The review question for the quali...

Background The increasing prevalence of diabetes is leading to a rise of eye diseases, augmenting the risk of sight-threatening complications. The aim of this study was to evaluate prevalence, awareness and practices regarding eye diseases among patients with diabetes in the canton of Vaud, Switzerland. Methods A cohort of 323 patients with diabet...

Switzerland is considered to have among the best performing healthcare systems among countries that are members of the Organisation for Economic Co-operation and Development. However, a 2011 analysis of the Swiss healthcare system identified fragmented provision of services, along with lack of coordination and integration as major deficits and sugg...

Background: Frail older people with multiple interacting conditions, polypharmacy, and complex care needs are particularly exposed to health care-related adverse events. Among these, anticoagulant-related thromboembolic and hemorrhagic events are particularly frequent and serious in older inpatients. The growing use of anticoagulants in this popul...

To obtain a comprehensive understanding of the job opinions of hospital professionals by conducting qualitative analyses of the open comments included in a job satisfaction survey and combining these results with the quantitative results.A cross-sectional survey targeting all Lausanne University Hospital professionals was performed in the fall of 2...

Dimensions and items included in the quantitative analyses (with Cronbach alpha’s and rating scales). (DOCX)

Signed chi squars indicating significant over- and under-representativeness of independent variable modalities in each thematic class. (DOCX)

Principal lexicometric characteristics of the different texts analysed. (DOCX)

Rationale, aims and objective: Whereas the Patient Assessment of Chronic Illness Care (PACIC) instrument measures the extent to which care received by patients is congruent with the Chronic Care Model, the 5As model emphasizes self-management and community resources, 2 key components of the Chronic Care Model. We aimed at comparing evaluation of d...