TY - JOUR
T1 - Aligning Ambition and Reality
T2 - A Multiple Case Study Into Synergistic Influences of Financial and Other Factors on the Outcomes of Integrated Care Projects
AU - Allers, Sanne
AU - Eijkenaar, Frank
AU - Schut, Frederik T.
AU - VAN RAAIJ, Erik M.
N1 - Publisher Copyright: © 2024 The Author(s).
PY - 2024/7/31
Y1 - 2024/7/31
N2 - Introduction: While the benefits of integrated care are widely acknowledged, its implementation has proven difficult. Together with other factors, financial factors are known to influence progress towards care integration, but in-depth insight in their influence on the envisioned outcomes of integrated care projects is limited. Methods: We conducted a multiple case study of four integrated care projects in the Netherlands. The projects were purposely sampled to be representative of integrated care in its different forms. A total of 29 semi-structured interviews were held with project members, both medical and non-medical staff. In addition, 141 documents were analyzed, including scientific publications and minutes of meetings. Based on elaborate project descriptions we deduced the synergistic influences of financial and other factors on the outcomes of the projects. Results: Financial factors have an important influence on integrated care projects, though this influence is neither deterministic nor isolated. This is because the likelihood of realizing a positive outcome is affected by the degree to which four key conditions are fulfilled: 1) willingness to change, 2) alignment of interests and uniformity goal, 3) availability of resources to change, and 4) effectiveness of management of external actors. Conclusion: Financial factors have an impact on the outcomes of integrated care projects and must be viewed in synergy with interrelated other factors. Crucial for realizing success in integrated care, a balance must be struck between the level of ambition set in a project and the reality of the prevailing key conditions.
AB - Introduction: While the benefits of integrated care are widely acknowledged, its implementation has proven difficult. Together with other factors, financial factors are known to influence progress towards care integration, but in-depth insight in their influence on the envisioned outcomes of integrated care projects is limited. Methods: We conducted a multiple case study of four integrated care projects in the Netherlands. The projects were purposely sampled to be representative of integrated care in its different forms. A total of 29 semi-structured interviews were held with project members, both medical and non-medical staff. In addition, 141 documents were analyzed, including scientific publications and minutes of meetings. Based on elaborate project descriptions we deduced the synergistic influences of financial and other factors on the outcomes of the projects. Results: Financial factors have an important influence on integrated care projects, though this influence is neither deterministic nor isolated. This is because the likelihood of realizing a positive outcome is affected by the degree to which four key conditions are fulfilled: 1) willingness to change, 2) alignment of interests and uniformity goal, 3) availability of resources to change, and 4) effectiveness of management of external actors. Conclusion: Financial factors have an impact on the outcomes of integrated care projects and must be viewed in synergy with interrelated other factors. Crucial for realizing success in integrated care, a balance must be struck between the level of ambition set in a project and the reality of the prevailing key conditions.
UR - http://www.scopus.com/inward/record.url?scp=85202546225&partnerID=8YFLogxK
U2 - 10.5334/ijic.7736
DO - 10.5334/ijic.7736
M3 - Article
C2 - 39100079
AN - SCOPUS:85202546225
SN - 1568-4156
VL - 24
JO - International Journal of Integrated Care
JF - International Journal of Integrated Care
IS - 3
M1 - 11
ER -