Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice – a Survey Study
Introduction: Multimorbidity challenges quality and sustainability of healthcare systems. Care groups were introduced in the Netherlands to promote integration of chronic primary care, but it remains unknown to which degree they facilitate this. This study therefore aims to determine whether Dutch g...
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2024-12-01
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| Series: | International Journal of Integrated Care |
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| Online Access: | https://account.ijic.org/index.php/up-j-ijic/article/view/8443 |
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| author | Toine E. P. Remers Simone A. van Dulmen Erik W. M. A. Bischoff Florien M. Kruse Marcel G. M. Olde Rikkert Patrick P. T. Jeurissen |
| author_facet | Toine E. P. Remers Simone A. van Dulmen Erik W. M. A. Bischoff Florien M. Kruse Marcel G. M. Olde Rikkert Patrick P. T. Jeurissen |
| author_sort | Toine E. P. Remers |
| collection | DOAJ |
| description | Introduction: Multimorbidity challenges quality and sustainability of healthcare systems. Care groups were introduced in the Netherlands to promote integration of chronic primary care, but it remains unknown to which degree they facilitate this. This study therefore aims to determine whether Dutch general practices perceive themselves to be capable of delivering integrated chronic care and uncover the role of care groups. Methods: We performed a survey study amongst 39 care groups and 65 healthcare providers within general practices (GPs and nurse practitioners). Results: 43% of healthcare providers within general practices are (very) dissatisfied with capabilities for chronic care to patients and 56% do not feel capable of delivering integrated care. Care groups and providers show alignment in their perception of some of the most important facilitators and barriers such as motivation and lack of time, but other factors are valued differently at both levels. Discussion: Our findings show inability of general practices to deliver integrated chronic care despite a health system that is inherently supportive of care integration and point to a mismatch between barriers and facilitators amongst practices and care groups, resulting in providers partly relying on their motivation in accommodating integrated chronic care. Conclusion: General practices are not sufficiently supported by care groups and national policies in delivering integrated chronic care. The identified mismatch between policy and practice warrants redesign of support from care groups to align policies with identified barriers and facilitators at the provider level. |
| format | Article |
| id | doaj-art-14f8d8cbe08b4864b5bc17e84c099a89 |
| institution | Kabale University |
| issn | 1568-4156 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj-art-14f8d8cbe08b4864b5bc17e84c099a892025-01-08T07:57:30ZengUbiquity PressInternational Journal of Integrated Care1568-41562024-12-0124131310.5334/ijic.84438339Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice – a Survey StudyToine E. P. Remers0https://orcid.org/0000-0002-4436-9542Simone A. van Dulmen1https://orcid.org/0000-0003-4003-8540Erik W. M. A. Bischoff2https://orcid.org/0000-0002-3323-8475Florien M. Kruse3https://orcid.org/0000-0003-3850-9331Marcel G. M. Olde Rikkert4https://orcid.org/0000-0003-1397-1677Patrick P. T. Jeurissen5https://orcid.org/0000-0002-4198-2448Radboud university medical center, Department of IQ Health, NijmegenRadboud university medical center, Department of IQ Health, NijmegenRadboud university medical center, Department of Primary and Community Care, NijmegenRadboud university medical center, Department of IQ Health, Nijmegen; Dutch Ministry of Health, Welfare, and Sport, Department Macro-Economic Affairs and Labour Market, the HagueRadboud university medical center, Department of Geriatric Medicine, Nijmegen; Radboud university medical center, Donders Institute for Brain Cognition and Behaviour, Department of Geriatric Medicine, Radboud Alzheimer Centre, NijmegenRadboud university medical center, Department of IQ Health, Nijmegen; Dutch Ministry of Health, Welfare, and Sport, Department Macro-Economic Affairs and Labour Market, the HagueIntroduction: Multimorbidity challenges quality and sustainability of healthcare systems. Care groups were introduced in the Netherlands to promote integration of chronic primary care, but it remains unknown to which degree they facilitate this. This study therefore aims to determine whether Dutch general practices perceive themselves to be capable of delivering integrated chronic care and uncover the role of care groups. Methods: We performed a survey study amongst 39 care groups and 65 healthcare providers within general practices (GPs and nurse practitioners). Results: 43% of healthcare providers within general practices are (very) dissatisfied with capabilities for chronic care to patients and 56% do not feel capable of delivering integrated care. Care groups and providers show alignment in their perception of some of the most important facilitators and barriers such as motivation and lack of time, but other factors are valued differently at both levels. Discussion: Our findings show inability of general practices to deliver integrated chronic care despite a health system that is inherently supportive of care integration and point to a mismatch between barriers and facilitators amongst practices and care groups, resulting in providers partly relying on their motivation in accommodating integrated chronic care. Conclusion: General practices are not sufficiently supported by care groups and national policies in delivering integrated chronic care. The identified mismatch between policy and practice warrants redesign of support from care groups to align policies with identified barriers and facilitators at the provider level.https://account.ijic.org/index.php/up-j-ijic/article/view/8443multimorbidityintegrated careprimary carecare groupshealth policygeneral practitioners |
| spellingShingle | Toine E. P. Remers Simone A. van Dulmen Erik W. M. A. Bischoff Florien M. Kruse Marcel G. M. Olde Rikkert Patrick P. T. Jeurissen Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice – a Survey Study International Journal of Integrated Care multimorbidity integrated care primary care care groups health policy general practitioners |
| title | Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice – a Survey Study |
| title_full | Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice – a Survey Study |
| title_fullStr | Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice – a Survey Study |
| title_full_unstemmed | Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice – a Survey Study |
| title_short | Policy Versus Practice: Facilitators and Barriers of Chronic Care Integration in Dutch General Practice – a Survey Study |
| title_sort | policy versus practice facilitators and barriers of chronic care integration in dutch general practice a survey study |
| topic | multimorbidity integrated care primary care care groups health policy general practitioners |
| url | https://account.ijic.org/index.php/up-j-ijic/article/view/8443 |
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