Zoekresultaat: 30 artikelen

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Duwtjes of druk?

De percepties van zorgprofessionals aangaande ‘nudging’ in ziekenhuizen

Tijdschrift Bestuurskunde, Aflevering 4 2020
Trefwoorden nudging, ethics, autonomy, healthcare, professionals
Auteurs Nienke Maria Huis in ’t Veld MSc, Rosanna Nagtegaal MSc en Prof. dr. Mirko Noordegraaf
SamenvattingAuteursinformatie

    ‘Nudging’ has been introduced as a policy and management tool as a way to influence behaviour without limiting choice. Nudging is mainly used to influence citizens’ behaviour but can also be used to influence the behavior of healthcare professionals. Examples include posters used to improve hand-hygiene compliance, or ‘default’ options in systems to reduce excessive prescriptions of specific medication. However, using nudges raises major worries and ethical issues, also in relation to the independence of healthcare professionals. While the scientific discussion about the desirability of nudges is extensive, the voices of healthcare professionals, who are the subjects of nudges, remain unheard. In this qualitative research we explore the perceptions of nudging held by various healthcare professionals. The interviews reveal that healthcare professionals are generally unfamiliar with the concept of nudging, but they do recognize nudges in their own field of practice. Furthermore, while they are predominantly positive about nudging, they also express concerns about the pressure on their autonomy. These concerns are related to changing professionalism and regulatory pressures in healthcare.


Nienke Maria Huis in ’t Veld MSc
N.M. Huis in ’t Veld, MSc is alumna aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.

Rosanna Nagtegaal MSc
R. Nagtegaal, MSc is promovenda aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.

Prof. dr. Mirko Noordegraaf
Prof. dr. M. Noordegraaf is hoogleraar Publiek Management aan de Universiteit Utrecht, departement Bestuurs- en Organisatiewetenschap.
Thema-artikel

Onafhankelijk onderzoek in het biomedische gebied

Tijdschrift Bestuurskunde, Aflevering 4 2019
Trefwoorden Medical research, independent research, pharmaceutical research, pharmaceutical industry, conflict of interest
Auteurs Prof. dr Frits R. Rosendaal
SamenvattingAuteursinformatie

    The author discusses the practices, problems and pitfalls research in the biomedical field with regard to conflicts of interests. Medicines are not ordinary products: the exclusive right to prescribe lies with the doctor, and because of the potentially life-saving nature of medicines, their use, price and availability is surrounded by emotions, especially when there is only one medicine available for a serious illness. Nonetheless, these products are marketed by companies that have a primarily commercial interest and, on the basis of those interests, engage in pricing and advertising activities. In the research on medicines, there is close cooperation between the pharmaceutical industry and doctor-researchers, whereby independence is at stake due to the large financial interests and reimbursements. This pushes the design, outcome and publication of research in a direction that is favorable to the pharmaceutical industry, but that is not financially the best direction for society, or medically for patients.


Prof. dr Frits R. Rosendaal
Prof. dr F.R. Rosendaal is hoogleraar en afdelingshoofd Klinische Epidemiologie in het Leids Universitair Medisch Centrum (LUMC). Hij doet onderzoek naar oorzaken van hart- en vaatziekten. In 2003 ontving hij de Spinozaprijs, de hoogste wetenschappelijke prijs in Nederland. Hij is gekozen lid van de Koninklijke Nederlandse Akademie van Wetenschappen en van de Duitse Akademie Leopoldina. In 2011 ontving hij een eredoctoraat van de Universiteit van Parijs Descartes.
Thema-artikel

Positieve beleidsevaluatie: hoe evaluatieonderzoek kan bijdragen aan beter beleid

Tijdschrift Bestuurskunde, Aflevering 3 2019
Trefwoorden positive public administration, positive evaluation, positive psychology, success, policy oriented learning
Auteurs Dr. Peter van der Knaap en Dr. Rudi Turksema
Samenvatting

    New insights from the field of positive psychology led to the insight that people learn more effectively from positive feedback. Policy evaluation aims to improve public policy programmes through contributing to both accountability and learning. This ambiguous ambition has contributed to a considerable body of research into the impact of policy evaluation. Too often the conclusion is that the outcomes of policy evaluations – which are often negative by nature – are sparsely used by policy makers. This has led to series of improvements in the way we carry out evaluations. First through technical improvements and then by more responsive approaches. Both have not led to the desired breakthrough. Building on a number of positive evaluation studies, we advance a more positive approach in policy evaluation. Focussing on the successes in policy programmes rather than on its failures may contribute to evaluation impact. Consequently, we think a more positive, appreciative approach and using data to find success in policy making is necessary for policy evaluators to be more effective. This article presents practical examples of positive policy evaluations and successful use of data in the domain of policy evaluation.


Dr. Peter van der Knaap

Dr. Rudi Turksema
Article

Access_open What Is Left of the Radical Right?

The Economic Agenda of the Dutch Freedom Party 2006-2017

Tijdschrift Politics of the Low Countries, Aflevering 2 2019
Trefwoorden radical right-wing populist parties, economic policies, welfare chauvinism, populism, deserving poor
Auteurs Simon Otjes
SamenvattingAuteursinformatie

    This article examines the economic agenda of the Dutch Freedom Party. It finds that this party mixes left-wing and right-wing policy positions. This inconsistency can be understood through the group-based account of Ennser-Jedenastik (2016), which proposes that the welfare state agenda of radical right-wing populist parties can be understood in terms of populism, nativism and authoritarianism. Each of these elements is linked to a particular economic policy: economic nativism, which sees the economic interest of natives and foreigners as opposed; economic populism, which seeks to limit economic privileges for the elite; and economic authoritarianism, which sees the interests of deserving and undeserving poor as opposed. By using these different oppositions, radical right-wing populist parties can reconcile left-wing and right-wing positions.


Simon Otjes
Assistant professor of political science at Leiden University and researcher at the Documentation Centre Dutch Political Parties of Groningen University.
Vrij

Van transitie naar transformatie van de jeugdhulp

Biedt de transactiekostentheorie aanknopingspunten voor meer kwaliteit, minder uitvoeringskosten en lagere administratieve lasten?

Tijdschrift Bestuurs­wetenschappen, Aflevering 2 2019
Auteurs Drs. Nanko Boerma en Dr. Bert Bröcking
SamenvattingAuteursinformatie

    In the implementation of the Dutch Youth Act, since the so-called ‘transition’ of 2015 under the responsibility of the municipalities, there are three major problems: the municipalities are short of money, the implementation of youth aid is accompanied by high administrative burdens and there are serious quality concerns, especially where different care providers must work together for one client. This article deals with the possibilities of the economic transaction cost theory for realizing improvements through organizing more effective collaboration between municipalities and healthcare providers. Transactions are a ‘forgotten’ cost source. There are three sources of transaction costs: limited rationality, opportunistic behavior and ‘asset specificity.’ In this article the authors analyze twelve problems documented in the literature on youth care from this perspective. This creates a framework from which municipalities can tackle these problems in order to improve the quality of youth care, to keep costs under control and to reduce the administrative burden. In a number of sectors and large projects ‘linking zones’ appear to be a way to increase the trust between players in a chain, so that transaction costs fall. Where poor cooperation between chain partners in youth care is a major cause of the problems, municipalities can make significant gains by establishing linking zones with care providers contracted by them. This article outlines the method in a linking zone.


Drs. Nanko Boerma
Drs. N. Boerma is van huis uit politicoloog en is voorzitter/directeur van de stichting Transactieland, het kennisinstituut voor transactie-innovatie.

Dr. Bert Bröcking
Dr. B.C. Bröcking is adviseur op het terrein van de jeugdhulp. Hij schreef over de rollen van cliënt, hulpverlener en overheid in de jeugdhulp.
Article

Consensus Democracy and Bureaucracy in the Low Countries

Tijdschrift Politics of the Low Countries, Aflevering 1 2019
Trefwoorden consensus democracy, bureaucracy, governance system, Lijphart, policymaking
Auteurs Frits van der Meer, Caspar van den Berg, Charlotte van Dijck e.a.
SamenvattingAuteursinformatie

    Taking Lijphart’s work on consensus democracies as our point of departure, we signal a major shortcoming in Lijphart’s focus being almost exclusively on the political hardware of the state structure, leaving little attention for the administrative and bureaucratic characteristics of governance systems. We propose to expand the Lijphart’s model which overviews structural aspects of the executive and the state with seven additional features of the bureaucratic system. We argue that these features are critical for understanding the processes of policymaking and service delivery. Next, in order to better understand the functioning of the Netherlands and Belgium as consensus democracies, we provide a short analysis of the historical context and current characteristics of the political-administrative systems in both countries.


Frits van der Meer
Frits van der Meer, Professor Institute Public Administration, Leiden University.

Caspar van den Berg
Caspar van den Berg, Campus Fryslân, University of Groningen.

Charlotte van Dijck
Charlotte van Dijck, PhD Fellow Research Foundation Flanders (FWO), KU Leuven Public Governance Institute.

Gerrit Dijkstra
Gerrit Dijkstra, Senior Lecturer, Leiden University.

Trui Steen
Trui Steen, Professor, KU Leuven Public Governance Institute.
Article

Transformative Welfare Reform in Consensus Democracies

Tijdschrift Politics of the Low Countries, Aflevering 1 2019
Trefwoorden consensus democracy, welfare state, social investment, transformative reform, Belgium and the Netherlands
Auteurs Anton Hemerijck en Kees van Kersbergen
SamenvattingAuteursinformatie

    This article takes up Lijphart’s claim that consensus democracy is a ‘kinder, gentler’ form of democracy than majoritarian democracy. We zoom in on contemporary welfare state change, particularly the shift towards social investment, and argue that the kinder, gentler hypothesis remains relevant. Consensus democracies stand out in regard to the extent to which their political institutions help to overcome the politically delicate intricacies of governing for the long term. We theorize the features that can help to solve the problem of temporal commitment in democracy through processual mechanisms and illustrate these with short case studies of the contrasting welfare state reform experiences in the Netherlands and Belgium.


Anton Hemerijck
Anton Hemerijck is Professor of Political Science and Sociology at the European University Institute (EUI) in Florence, Italy.

Kees van Kersbergen
Kees van Kersbergen is Professor of Comparative Politics at the Department of Political Science of Aarhus University, Denmark.
Artikel

Naar bestuursgericht toezicht in de zorg: een zoektocht naar passendheid

Tijdschrift Bestuurskunde, Aflevering 4 2018
Trefwoorden healthcare governance, management-oriented regulation, experimenting, recoupling, reflective regulation
Auteurs Dr. Annemiek Stoopendaal en Dr. Hester van de Bovenkamp
Samenvatting

    In this article, we discuss how regulation of governance in healthcare has been shaped over the past decade. We describe the presuppositions under this movement. Searching and balancing was needed to meet the complexity of care management. This has to do with the fact that the external pressure on the regulator after incidents is high. Due to this pressure, it is necessary to constantly ensure that management-oriented regulation does not narrow to the supervision on the actor with final responsibility. The regulation of good governance requires reflectivity of the inspectors and is aimed at stimulating recoupling between management and shop floors. This requires space for experimentation for both managers and inspectors. To provide this space, we do not only need a political and social debate about the quality of care and its management, but also attention and appreciation for the difficult considerations of organizing care.


Dr. Annemiek Stoopendaal

Dr. Hester van de Bovenkamp
Artikel

Access_open Van toezicht op kwaliteit naar toezicht op bestuur

Ontwikkeling van bestuursgericht toezicht in semipublieke sectoren

Tijdschrift Bestuurskunde, Aflevering 4 2018
Trefwoorden Inspection, Governance, Semipublic sector, Quality improvement, Opportunities and risks
Auteurs Dr. Meike Bokhorst, Dr. Marieke van Genugten, Dr. Mirjan Oude Vrielink e.a.
Samenvatting

    In Dutch semi-public sectors of education, healthcare, and housing there is a tendency towards governance based inspection. The attention of inspectorates shifts from inspection on minimum quality standards to inspection on governance based quality improvement. The aim of this special issue is to learn more about the opportunities and risks of governance based inspection. The survey and sector articles show that governance based inspection (1) puts the responsibility of governors to stimulate quality on the agenda, (2) makes governors more aware of the quality targets they want to achieve within their organisations, and (3) has a deregulating effect. However, the risks are (1) reregulation via sector norms, (2) a lack of reality checks, and (3) a narrow focus on governors instead of the quality of public services. Consequently, inspectors have to learn new skills and competences. All in all, governance based inspection can complement but not replace other ways of inspection.


Dr. Meike Bokhorst

Dr. Marieke van Genugten

Dr. Mirjan Oude Vrielink

Prof. dr. Thomas Schillemans

    Since 2018, the Department of Public Administration of the Faculty of Behavioural, Management and Social Sciences (BMS) of the University of Twente, in close cooperation with the municipality Zwolle, the Province of Overijssel and BMC advice, have been organizing the yearly Van Poelje lecture (named after administrative scientist and founder of Dutch Public Administration Gerrit van Poelje). The first lecture took place on 29 January 2018 in the ‘Grote Kerk’ in Zwolle. The subject of the lecture was the secret of successful regions: which policy works? Otto Raspe of the Dutch Planning Agency for the Environment delivered the keynote speech. Presentations from the administrative field were given by Henk Jan Meijer (mayor of the municipality Zwolle) and Staf Depla (alderman of the municipality Eindhoven) who respectively addressed the cooperation in the regions Zwolle and South-East Brabant. Bert van Delden responded from the point of view of the Home Office (he deputized for his minister, Kajsa Ollongren). After a short debate, the afternoon was closed by Marcel Boogers (senior advisor at BMC and professor at the University of Twente) with a scientific reflection on the subject of the lecture. The main message of the keynote speaker Otto Raspe was that an urban region is successful if it is able to use its agglomeration advantages. This is possible by seeking connections between clusters and the knowledge infrastructure, and between human capital and a pleasant living and social climate.


Dr. Rik Reussing
Dr. G.H. Reussing is onderwijscoördinator van de joint degree Public Governance across Borders aan de Universiteit Twente en redactiesecretaris van Bestuurswetenschappen.
Artikel

Herstel en vertrouwen: professionals, ervaringswerkers en de herstelvisie in de Nederlandse geestelijke gezondheidszorg

Tijdschrift Beleid en Maatschappij, Aflevering 3 2018
Trefwoorden Trust, Recovery, Professionals, Peer specialists, Habermas
Auteurs Marijn Kester MSc en Mr. dr. Olivier Lingbeek
SamenvattingAuteursinformatie

    This text wants to draw attention to the question: How do peer specialists build a bridge between the modus operandi of health care professionals and the lifeworld problems of clients receiving mental health care? The Dutch mental healthcare system has recently been host to a range of new developments. Two new trends can be distinguished, going by the name of ‘Recovery-oriented healthcare’ and the introduction of ‘Peer Specialists’. These coincide with changes in budget and organization of treatment. There is an increased awareness of the need for efficiency and cost reduction in the organization of care. The meaning and use of recovery-centered approaches and working with peer specialists remain fairly marginal enterprises due to ever increasing pressure emanating from execution of regulations and administrative procedures, and an accompanying decrease of professional autonomy. In the light of Habermas’ theoretical framework, it is an emphasis on a system-oriented organization of care that cause new approaches to barely be able to find a considerable place in the contemporary practice of mental healthcare in the Netherlands. Trust is identified as an essential foundation on the basis of which future principles of organization should be developed.


Marijn Kester MSc
Marijn Kester MSc is medisch socioloog.

Mr. dr. Olivier Lingbeek
Mr. dr. Olivier Lingbeek heeft een eigen adviesbureau op het gebied van bestuurlijke vraagstukken met betrekking tot planologie en sociologie.
Artikel

Lokale netwerken als instrument voor centraal beleid?

De relativiteit van metagovernance

Tijdschrift Bestuurskunde, Aflevering 2 2018
Trefwoorden metagovernance, Local networks
Auteurs Filip De Rynck, Caroline Temmerman en Joris Voets
Samenvatting

    Collaboration between public actors and social partners is becoming increasingly important as an administrative solution for complex societal challenges in health care, spatial development, mobility management or water management. In this article we focus on the relationship between the central Flemish government and local networks that are set up by this government. In the scientific literature much attention is paid to the concept of metagovernance as analytical perspective to analyze the relationship between the government and networks. The concept offers the government a toolbox with roles and instruments from which it can choose to support and stimulate networks in order to achieve the desired network results. However, our research shows that such an approach is not sufficient to capture the relationship between the central government and local mandated networks in Flanders. We argue for a broader interpretation of the concept of metagovernance, in which the dynamics of local networks are viewed as the outcome of power relations between actors that are represented at both local and central level and that are intertwined with each other. Only in this way will we we understand why certain choices are made about local mandated networks, why local networks show a lack of dynamism and why local actors in local networks also do not want local networks to become more dynamic and effective. We do notice that the pressure on these arrangements is increasing, partly due to new actors who are not involved in these arrangements.


Filip De Rynck

Caroline Temmerman

Joris Voets
Casus

Access_open De winsten van zorginstellingen

Tijdschrift Beleid en Maatschappij, Aflevering 1 2018
Trefwoorden health-care organizations, financial accounts, for-profit or not-for-profit, Profits, economies of scale
Auteurs Prof. dr. Jeroen Suijs en Prof. dr. Harrie Verbon
SamenvattingAuteursinformatie

    In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.
    We calculate and describe profits obtained by health organizations in The Netherlands in the years 2014 and 2015. We distinguish between profit and not-for-profit organizations. We find that on average net profits amount to about 2 percent on turnover with a peak of more than 3 percent for mental-healthcare organizations. If we take the size of organizations into account, we find that for-profit organizations with a turnover of less than 1 million euro tend to have on average net profit rates of 4 percent to more than 5 percent with peaks amounting to more than 50 percent. We are not yet able to come up with explanations for these excessively high profit rates in parts of the Dutch health care sector. On the other hand, the highest losses can be found in small-sized organizations as well. We delved deeper into the financial accounts of a few for-profit organizations and found indications of misreporting of turnover or number of treatments. On the other hand, bad management and unhealthy cost structures might explain why some organizations incur excessive big losses. The sector does not appear to be well monitored by the government.


Prof. dr. Jeroen Suijs
Prof. dr. Jeroen Suijs is hoogleraar financial accounting aan de Erasmus Universiteit in Rotterdam.

Prof. dr. Harrie Verbon
Prof. dr. Harrie Verbon is hoogleraar openbare financiën aan de Universiteit van Tilburg.
Casus

Access_open In de zorg voelt de winst van de een nu als het verlies van de ander

Naar een beter begrip van winst in de zorg door in de discussie over winst in de zorg onderscheid te maken tussen een leefwereld- en een systeemwereldperspectief

Tijdschrift Beleid en Maatschappij, Aflevering 1 2018
Trefwoorden Profit, healthcare providers, health insurers, lifeworld perspective, system perspective
Auteurs Drs. Piet de Bekker en Dr. Eric van der Hijden
SamenvattingAuteursinformatie

    In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.
    Systematic research on societal responses to profit in healthcare is scarce. It is a highly complex topic, with many tensions in the public and political debate. In a recent Dutch publication on profit, authors use a ‘lifeworld’ perspective to assess profit in their research, while their assessment could have been different using a ‘system’ perspective. Both perspectives have their merit, and debate on the role of profit in health care should separate the two perspectives. We describe both perspectives and use them to clarify whether making a profit is different from paying that profit to shareholders. We conclude that in healthcare, the general tension between the perspectives can be summarized as ‘profit for one actor may feel – but isn’t always – someone else’s loss’. Recognizing these tensions and searching for a strategy to align interests in which everyone gains may help the current stagnated debate on this issue in the Netherlands.


Drs. Piet de Bekker
Drs. Piet de Bekker is PhD-onderzoeker aan de Vrije Universiteit Amsterdam, Talma Instituut, sectie Gezondheidseconomie. Hij is tevens partner en adviseur bij Zorgvuldig Advies.

Dr. Eric van der Hijden
Dr. Eric van der Hijden is teamleider Gepaste Zorg aan de Vrije Universiteit Amsterdam, Talma Instituut, sectie Gezondheidseconomie. Hij is tevens beleidsadviseur zorginkoop bij Zilveren Kruis Zorgverzekeringen.
Artikel

Verkeer als stelsel met stelselverantwoordelijkheid voor veiligheid?

Naar een moderne governance opvatting van ‘co-responsibility’ bij stelsels

Tijdschrift Bestuurskunde, Aflevering 1 2018
Trefwoorden traffic safety, systems approach, governance, co-responsibility
Auteurs Dr. mr. Dick Ruimschotel
Samenvatting

    Lack of safety leading to death or injury has many aspects: personal violence, traffic, accidents at home or the work place, not to mention other external sources as radiation and fine dust or internal sources like diseases. In this paper we restrict ourselves to the lack of safety in traffic as a system, and address the following questions: (1) Is traffic a system with one dominant responsible actor (Ministry of Traffic)? (2) What explanations are offered for the lack of safety? (3) Who is responsible for safety? (4) What sort of interventions are suitable for enhancing safety? and (5) What type of process/consultancy is most appropriate for answer the preceding questions?
    The paper arrives at its conclusions via an indirect way, namely a short analysis of what a system comprises and what constitutes an explanation, responsibility and effectiveness. It appears that we are all causally involved in the lack of safety, and we are all responsible at all levels of society: micro-individual, meso-organizational and macro-societal. Therefore a promising route to maximize safety is a governance perspective comprising multiple stakeholder co-responsibility. It remains to be seen whether this perspective should replace the predominant command and control governance or complement it.


Dr. mr. Dick Ruimschotel
Artikel

Uitdagingen voor bestuur en politiek op gemeenteniveau: het burgerperspectief

Tijdschrift Bestuurs­wetenschappen, Aflevering 3 2017
Auteurs Dr. Jeroen van der Waal, Babs Broekema MSc en Dr. Eefje Steenvoorden
SamenvattingAuteursinformatie

    For the legitimacy and ability of governments it is crucial to have insight in the worries of citizens about society and politics. In the Netherlands these worries are at the national level systematically mapped by the Dutch Social and Cultural Planning Agency (SCP) through their Continuous Research Citizen Perspectives (COB) for almost ten years now. At the local level there is a lack of information about what worries citizens. Insight in locally experienced problems will probably become even more important in the coming years because of the recent decentralizations of national governmental tasks to the municipalities. This article investigates which problems citizens perceive in their municipalities based on an analysis of data from the Local Electoral Research (LKO). The authors find a number of striking differences with the problems that are perceived at the national level in the same period. The municipal issues citizens mention offer opportunities, but they also point to the limited impact force of the municipal level of government. All in all the research findings are indicative of a substantial added value of the LKO with respect to the already longer running COB.


Dr. Jeroen van der Waal
Dr. J. van der Waal is universitair hoofddocent politieke sociologie bij de vakgroep Sociologie aan de Erasmus Universiteit Rotterdam.

Babs Broekema MSc
B. Broekema MSc is promovendus aan de Erasmus Universiteit Rotterdam. Aan dezelfde universiteit deed ze een master Bestuurskunde, Beleid en Politiek.

Dr. Eefje Steenvoorden
Dr. E.H. Steenvoorden is universitair docent politieke sociologie bij de vakgroep Sociologie aan de Erasmus Universiteit Rotterdam.

    In this feature authors discuss recent research findings that are of interest to readers of Beleid en Maatschappij.


Prof. dr. Monique Kremer
Prof. dr. Monique Kremer is werkzaam bij de WRR en als bijzonder hoogleraar Actief Burgerschap bij de afdeling Sociologie aan de Universiteit van Amsterdam.

    Nationaal en internationaal staat onderzoek dat maatschappelijk relevant is, wetenschappelijk gezien hoge kwaliteit heeft, en zowel integer als efficiënt wordt uitgevoerd in de schijnwerpers. Het achterliggende idee is dat alleen zo de gewenste maatschappelijke impact kan worden bereikt. Door het bevorderen van verantwoorde onderzoekspraktijken, waarbij er onder andere expliciet aandacht is voor aspecten als stakeholderparticipatie, interdisciplinaire samenwerking, replicatie en systematische reviews, kunnen financiers of programmeurs van onderzoek hieraan bijdragen. In dit artikel wordt een overzicht gegeven van de wijze waarop ZonMw dat doet als kennisprogrammeur op het gebied van het gezondheidsonderzoek. Hiertoe is een toetsingskader ontwikkeld en toegepast op zestien lopende onderzoeksprogramma’s, dat ook voor andere domeinen en actoren betekenis heeft. Een belangrijke aanbeveling is dat ‘verantwoord programmeren’ een eigen kennisbasis behoeft om de toegevoegde waarde ervan te kunnen bepalen. Naast investeringen in metaonderzoek vraagt dat om een goede monitoring en informatievoorziening bij de kennisprogrammeur.


Wendy Reijmerink
Wendy Reijmerink is stafmedewerker Strategie en Innovatie bij ZonMw. Zij werkt aan een promotie over de maatschappelijke impact van publieke kennisprogrammering.

Wija Oortwijn
Wija Oortwijn is sectorleider Zorg bij Ecorys. Zij heeft jarenlange ervaring met evaluaties van beleid en onderzoeksprogramma’s alsmede impactanalyses op het terrein van de zorg.
Artikel

Waarom zorgorganisaties in Nederland fuseren

Tijdschrift Bestuurskunde, Aflevering 3 2016
Trefwoorden merger motives, healthcare executives, health policy, healthcare reform, healthcare mergers
Auteurs Dr. Jeroen Postma en Anne-Fleur Roos MSc.
Samenvatting

    In many OECD countries, healthcare sectors have become increasingly concentrated as a result of mergers. However, detailed empirical insight into why healthcare providers merge is lacking. Also, we know little about the influence of national healthcare policies on mergers. We fill this gap in our knowledge by analyzing the results of a survey study among Dutch executives about mergers between healthcare organizations in the period from 2005 to 2012. During this period, Dutch healthcare providers faced a number of policy changes, including increased competition, more pressure from purchasers (health insurers), growing financial risks, de-institutionalization of long-term care and decentralization of healthcare services to municipalities. Our study shows that Dutch healthcare providers predominantly merge to improve the provision of healthcare services and to strengthen their market position. Efficiency and financial reasons are also important drivers of merger activity in healthcare. Motives for mergers seem to be related to changes in health policy, in particular to the increasing pressure from competitors, insurers and municipalities.


Dr. Jeroen Postma

Anne-Fleur Roos MSc.
Artikel

Gezocht: Burgerparticipatie (voor vaste relatie)

Een vergelijkende gevalsstudie naar 26 lokale netwerken in het sociale domein in de regio Arnhem

Tijdschrift Bestuurskunde, Aflevering 1 2016
Trefwoorden citizen participation, co-production, local networks, decentralization, collaboration
Auteurs Rigtje Passchier MSc en Dr. Jelmer Schalk
SamenvattingAuteursinformatie

    In 2015, Dutch local governments have become responsible for youth care, social welfare, employment and income assistance programs, as a result of decentralization. Many municipalities have set up service delivery networks and community teams, in which they collaborate with healthcare providers and civic organizations to build integrated care services. It is assumed that these networks will improve outcomes in terms of enhanced people’s self-reliance and healthcare cost control; by operating close to citizens they are in a position to know the client, activate a client’s social network and mobilize specialized professional expertise if necessary. However, a comparative case study of 26 emerging local networks in the Arnhem area indicates that healthcare providers use the networks mainly for presentation purposes in an effort to secure business continuity, that the role of local governments is fuzzy, and that citizen participation only thrives when actively encouraged in a climate of trust.


Rigtje Passchier MSc
R. Passchier MSc is interim manager voor de publieke zaak en promovenda aan de Universiteit Leiden.

Dr. Jelmer Schalk
Dr. J. Schalk is universitair docent aan de Universiteit Leiden.
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