ArticleInternational journal of health policy and management2022
Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study.
Article in International journal of health policy and management, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Discretion at the margins: An observational study of community pharmacists' adaptive practices in supporting migrant and ethnic minority health.Exploratory research in clinical and social pharmacy · 2026Article
- Process and Strategies for Implementing an Antenatal Psychosocial Clinical Decision Support System Within an Inter-Organisational Care Context: The Born in Belgium Professionals Platform.Healthcare (Basel, Switzerland) · 2026Article
- Impediments to transforming the healthcare delivery system: shifting the paradigm from provider centric to patient centric.Frontiers in health services · 2026Article
- Health-related quality of life and patient experiences regarding care transitions in hospitalized older patients with chronic diseases.Scientific reports · 2025Article
- Collaboration between ambulance services and primary care: a scoping review protocol.BMJ open · 2025Article
- Key Motivators and Framework for Integrated Care by Family Physician Team Members in Urban China.International journal of health policy and management · 2025Article
- China's coordinated tripartite medical reform: strategic balancing of interests among pharmaceuticals, healthcare, and health insurance.Frontiers in public health · 2025Article
- Introduction to the Supplement 'Coming together to fight cancer: a series of policy briefs taking stock of the implementation of Europe's Beating Cancer Plan in Belgium'.Archives of public health = Archives belges de sante publique · 2024Article
- Evaluation study of the urban governance of the COVID-19 crisis in the city of Antwerp.BMC public health · 2024Article
- How does the external context affect an implementation processes? A qualitative study investigating the impact of macro-level variables on the implementation of goal-oriented primary care.Implementation science : IS · 2024Article
- Multimorbidity healthcare expenditure in Belgium: a 4-year analysis (COMORB study).Health research policy and systems · 2024Article
- Primary Care Academy: lessons learned from a large-scale innovative primary care project.Frontiers in public health · 2024Article
- Article
- Addressing health inequity during the COVID-19 pandemic through primary health care and public health collaboration: a multiple case study analysis in eight high-income countries.International journal for equity in health · 2023Article
- Population health management in Belgium: a call-to-action and case study.BMC health services research · 2023Review
- Local initiative supports case isolation and contact tracing during a SARS-CoV-2 surge in summer 2020: a community case study in Antwerp, Belgium.Frontiers in public health · 2023Article
- The Tale of Nine Belgian Health Ministers and a Multi-level Fragmented Governance System: Six Guiding Principles to Improve Integrated Care, Responsiveness, Resilience and Equity; A Response to the Recent Commentaries.International journal of health policy and management · 2023Article
- Integrated Care Policies and Politics in Belgium: Conceptual, Contextual and Governance Linkages for More Effective Integrated Care Policy Management Comment on "Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study".International journal of health policy and management · 2023Article
- Developing evaluation capacities in integrated care projects: Lessons from a scientific support mission implemented in Belgium.Frontiers in public health · 2022Article
- Reducing Internally Generated Demand Through Scheduled Communication Time in a Remote Salaried Family Medicine Clinic.Journal of primary care & community healthArticle
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlobally, health systems have been struggling to cope with the increasing burden of chronic diseases and respond to associated patient needs. Integrated care (IC) for chronic diseases offers solutions, but implementing these new models requires multi-stakeholder action and integrated policies to address social, organisational, and financial barriers. Policy implementation for IC has been little studied, especially through a political lens. This paper examines how IC policies in Belgium were developed over the last decade and how stakeholders have played a role in these policies.
methodsWe used a case study design. After an exploratory document review, we selected three IC policies. We then interviewed 25 key stakeholders in the field of IC. The stakeholder analysis entailed a detailed mapping of the stakeholders' power, position, and interest related to the three selected policies. Interview participants included policy-makers, civil servants (from ministry of health and health insurance), representatives of health professionals' associations, academics, and patient organisations. Additionally, a processual analysis of IC policy processes (2007-2020) through literature review was used to frame the interviews by means of a chronic care policy timeline.
resultsIn Belgium, a variety of policy initiatives have been developed in recent years both at central and decentralised levels. The power analysis and policy position maps exposed tensions between federal and federated governments in terms of overlapping competence, as well as the implications of the power shift from federal to federated levels as a consequence of the 2014 state reform.
conclusionThe 2014 partial decentralisation of healthcare has created fragmentation of decisive power which undermines efforts towards IC. This political trend towards fragmentation is at odds with the need for IC. Further research is needed on how public health policy competences and reform durability of IC policies will evolve.
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