ArticleInternational journal of integrated care
What Makes Integration of Chronic Care so Difficult? A Macro-Level Analysis of Barriers and Facilitators in Belgium.
Article in International journal of integrated care. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed.
- Trial
- Are long-term care systems aligned with person-centered integrated care? Evidence from the Western Pacific.Health policy (Amsterdam, Netherlands) · 2025Review
- Towards a generic competency framework for all primary care professionals: a qualitative research protocol.BMC primary care · 2025Article
- Adopting tailored interprofessional protocols in general practice: barriers, strategies, and lessons learned from a CFIR-guided qualitative study.BMC health services research · 2025Article
- Entangled in complexity: An ethnographic study of organizational adaptability and safe care transitions for patients with complex care needs.Journal of advanced nursing · 2025Article
- Health-related quality of life and patient experiences regarding care transitions in hospitalized older patients with chronic diseases.Scientific reports · 2025Article
- Enablers and constraints influencing implementation of a novel, multi-site community-based frailty programme: perspectives of leaders and implementers.BMC geriatrics · 2025Article
- Negotiating care in organizational borderlands: a grounded theory of inter-organizational collaboration in coordination of care.BMC health services research · 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
- Primary Care Academy: lessons learned from a large-scale innovative primary care project.Frontiers in public health · 2024Article
- Population health management in Belgium: a call-to-action and case study.BMC health services research · 2023Review
- Implementing Four Transitional Care Interventions for Older Adults: A Retrospective Collective Case Study.The Gerontologist · 2023Article
- Scale-up of a chronic care model-based programme for type 2 diabetes in Belgium: a mixed-methods study.BMC health services research · 2023Article
- Stakeholders' experiences and perception on transitional care initiatives within an integrated care project in Belgium: a qualitative interview study.BMC geriatrics · 2023Article
- Developing evaluation capacities in integrated care projects: Lessons from a scientific support mission implemented in Belgium.Frontiers in public health · 2022Article
- Evaluation of the Implementation of Integrated Primary Care for Patients with Type 2 Diabetes and Hypertension in Belgium, Cambodia, and Slovenia.International journal of integrated careArticle
- Scale-Up of Integrated Care Interventions for Chronic Diseases in Diverse Settings.International journal of integrated careArticle
- Qualitative and Quantitative Evaluation of an Innovative Primary and Secondary Diabetes Clinic in Western Sydney.International journal of integrated careArticle
- Slowing Down to Accelerate: The Innovation of the Fundamentals of Integrated Care Governance.International journal of integrated careArticle
- Aligning Ambition and Reality: A Multiple Case Study Into Synergistic Influences of Financial and Other Factors on the Outcomes of Integrated Care Projects.International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAlthough many countries have been implementing integrated care, the scale-up remains difficult. Macro-level system barriers play an important role. By selecting three key policies, which have implemented integrated care in Belgium over the last 10 years, we aim to go beyond the identification of their specific barriers and facilitators to obtain an overarching generic view.
methods27 participants were purposefully selected, to include all important stakeholders involved on the macro-level in chronic care in Belgium. Semi-structured interviews were guided by a timeline of policies and an inductive thematic analysis was performed.
resultsBarriers and facilitators were identified on both health care and policy level. The major factors restraining the scale-up of integrated care are the fee-for-service reimbursement system, limited data sharing and the fragmentation of responsibilities between different levels of government. Remarkably, these factors strongly interact. DISCUSSION: This paper highlights the importance of homogenization of responsibilities of governments regarding integrated care and the interdependency of policy and health care system factors. A whole system change is needed instead of the current Belgian model of prolonged search for common ground between conflicting opinions. Political commitment and citizen participation will be crucial.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.