The Role of Spitex Organizations as Care Coordinators in Switzerland’s Home Care System: A Functional Analysis Based on the Care Triangle Model

Abstract

Population ageing and the increasing number of people with chronic diseases create the need to develop integrated forms of home care. In Switzerland, this direction is expressed in the ambulant vor stationär strategy, which gives priority to community-based care over inpatient care. The aim of this article is to analyze the role of Spitex organizations as care coordinators in the home care system, using the care triangle model comprising the patient, family caregivers, and the attending physician. The main research problem concerns the way in which Spitex stabilizes cooperation among these three actors and the barriers that limit the full use of its coordinative potential. A qualitative content analysis was applied, including a critical review of the scientific literature and institutional documents concerning home care in Switzerland. The findings indicate that Spitex plays a key integrative role, encompassing nursing, educational, observational-informational, and coordinative functions that stabilize the care triangle and prevent overload in its individual elements. At the same time, the coordinative functions of Spitex are constrained by financial, structural, institutional, staffing, and technological barriers. Th e conclusions emphasize the need for systemic recognition of coordination as a financed service, standardization of cross-sector cooperation, and development of digital tools supporting information exchange. The article also indicates the need for further research on the effectiveness of Spitex coordination and its implications for healthcare practice, particularly in strengthening interprofessional cooperation and supporting family caregivers.