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Jaar 2016 x
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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