[What promotes and hinders integration of oral care in general care? Part 2. Policy, organization, implementation]

To identify facilitators and barriers to integrate oral healthcare into general healthcare for frail elderly, 41 participants from 10 different groups of (professional) caregivers and recipients (residents living at home and nursing home patients) in the east of the Netherlands were interviewed. They were asked about functional integration at the macro (system), meso (organizational and interprofessional) and micro (patient care) level. After thematic analysis of the interviews, the results were refined on the basis of a workshop with 52 stakeholders. Subsequently, two main themes for functional factors were identified: 1. compartmentalized care systems and 2. deficient interprofessional and communication infrastructure. Barriers to integration are lack of integrative policies, compartmentalized education (macro level), poor embedding of oral healthcare in healthcare procedures and diagnostic tools, poor communication systems (meso level) and poor interprofessional skills (micro level). The integration of oral healthcare providers in care teams, agenda-setting during interdisciplinary consultations (meso level) and integration of oral care and care in individual care plans (micro level) promote integration. Oral healthcare for the elderly is poorly integrated in general care in the Netherlands.