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The influence of institutions and culture on health policies: different approaches to integrated care in England and The Netherlands
Author(s) -
Kümpers Susanne,
Van Raak Arno,
Hardy Brian,
Mur Ingrid
Publication year - 2002
Publication title -
public administration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.313
H-Index - 93
eISSN - 1467-9299
pISSN - 0033-3298
DOI - 10.1111/1467-9299.00307
Subject(s) - hierarchy , health care , incentive , integrated care , politics , health policy , public economics , business , social care , set (abstract data type) , public administration , economic growth , economics , political science , medicine , nursing , computer science , programming language , law , microeconomics , market economy
The concept of integrated care has assumed growing importance on the policy agendas both in England and The Netherlands and elsewhere. It is characterized as health and health care‐related social care needed by patients with multi‐faceted needs. This article compares policy approaches to integrated care in England and The Netherlands. Differing political strategies and conditions for integrated care correspond to the dissimilarities in the institutional structure and culture of their health care systems. Health care systems are understood as specific national and historical configurations. We review the last decade’s relevant policy processes, using the concepts of hierarchy, market and network. The state health care system in England relies mainly on hierarchical steering, thus creating tight network structures for integrated care on the local level. The Netherlands, with its health care system in a public‐private mix, has set incentives for voluntary, loosely coupled and partly market‐driven cooperation on the local level. Implications for success or failure are mixed in both configurations. Policy recommendations have to be tailored to each systems’ characteristics.