TY - JOUR
T1 - Overcoming fragmentation in health care: chronic care in Austria, Germany and the Netherlands
AU - Nolte, Ellen
AU - Knai, Cecile
AU - Hofmarcher, Maria
AU - Conklin, Annalijn
AU - Erler, Antje
AU - Elissen, Arianne
AU - Flamm, Maria
AU - Fullerton, Brigit
AU - Soennichsen, Andreas
AU - Vrijhoef, Hubertus J. M.
PY - 2012/1
Y1 - 2012/1
N2 - The growing recognition of care fragmentation is causing many countries to explore new approaches to healthcare delivery that can bridge the boundaries between professions, providers and institutions and so better support the rising number of people with chronic health problems. This paper examines the role of the regulatory, funding and organisational context for the development and implementation of approaches to chronic care, using examples from Austria, Germany and the Netherlands. We find that the three countries have implemented a range of policies and approaches to achieve better coordination within and across the primary and secondary care interface and so better meet the needs of patients with chronic conditions. This has involved changes to the regulatory framework to support more coordinated approaches to care (Austria, Germany), coupled with financial incentives (Austria, Germany) or changes in payment systems (the Netherlands). What is common to the three countries is the comparative 'novelty' of policies and approaches aimed at fostering coordinated care; however, the evidence of their impact remains unclear.
AB - The growing recognition of care fragmentation is causing many countries to explore new approaches to healthcare delivery that can bridge the boundaries between professions, providers and institutions and so better support the rising number of people with chronic health problems. This paper examines the role of the regulatory, funding and organisational context for the development and implementation of approaches to chronic care, using examples from Austria, Germany and the Netherlands. We find that the three countries have implemented a range of policies and approaches to achieve better coordination within and across the primary and secondary care interface and so better meet the needs of patients with chronic conditions. This has involved changes to the regulatory framework to support more coordinated approaches to care (Austria, Germany), coupled with financial incentives (Austria, Germany) or changes in payment systems (the Netherlands). What is common to the three countries is the comparative 'novelty' of policies and approaches aimed at fostering coordinated care; however, the evidence of their impact remains unclear.
U2 - 10.1017/S1744133111000338
DO - 10.1017/S1744133111000338
M3 - Article
C2 - 22221931
SN - 1744-1331
VL - 7
SP - 125
EP - 146
JO - Health Economics, Policy and Law
JF - Health Economics, Policy and Law
IS - 1
ER -