Preserving Continuity and Trust in Primary Care: Strategies for Implementing Team-Based Models in South Tyrol, Italy

Abstract

Continuity of care is fundamental to the efficacy of primary healthcare, fostering trust, enhancing patient satisfaction, and improving health outcomes. However, the implementation of Ministerial Decree 77/2022, which advocates for team-based care in multidisciplinary Community Health Centers, presents challenges to these established principles. This article proposes strategies to maintain continuity and trust whilst supporting the reform objectives, specifically tailored to the unique linguistic and cultural context of the Autonomous Province of Bolzano-South Tyrol. A synthesis of regional healthcare reports, academic literature, and practical insights from implementing Ministerial Decree 77/2022 was performed to develop strategies addressing challenges such as ensuring continuity, minimizing administrative burdens, and promoting patient and general practitioner engagement. Strategies include establishing Community Health Centers as integration hubs, assigning primary providers within teams, formalizing personalized care contracts, leveraging digital tools for collaboration, and expanding the roles of nurses and care coordinators. Additional measures focus on building infrastructure for telemedicine and home-based care, engaging patients through transparent communication and feedback loops, and preserving GP autonomy through flexible participation models and incentives. Strategies adapted to accommodate South Tyrol's demographic, cultural, and systemic characteristics can maintain continuity and trust during the transition to team-based care. By addressing key risks and fostering collaboration among stakeholders, these reforms can enhance healthcare delivery without compromising the principles of personalized, patient-centered care.

Keywords: South Tyrol; continuity of care; digital health integration; general practitioners; healthcare workflows; multidisciplinary care; patient engagement; primary care reform; trust.

Figure 1

Continuity of care in South Tyrol: Balancing benefits and risks. The dual-layer Venn diagram illustrates the interplay between the key benefits of continuity in primary care and the risks posed by reforms under Ministerial Decree 77/2022 in South Tyrol. (Left panel) The benefits include trust and satisfaction derived from strong GP–patient relationships, improved health outcomes through better adherence to treatment, and enhanced efficiency by reducing healthcare costs and hospitalizations. The overlapping area highlights the value of continuity in primary care, where these benefits converge to provide comprehensive and patient-centered care. (Right panel) The risks to continuity include the loss of personal connection caused by fragmented care under team-based models, increased bureaucracy from digital tools and administrative tasks, and geographical and cultural barriers unique to South Tyrol’s rural and bilingual context. The intersection of these risks underscores the potential for undermined continuity in primary care, where multiple challenges disrupt effective care delivery.

Figure 2

Framework of proposed strategies to preserve continuity in South Tyrol’s primary care reform.