Analysing hydra-headed integrated care: a pilot case study in Flanders (Belgium)

Ezra Dessers, Hubertus JM Vrijhoef, Geert Van Hootegem, Steven Dhondt, Anke Mutsaerts, Sam Pless, Steven Van den Oord, Denise van der Klauw, Ellen Vanermen, Nick Verhaeghe, Sonja Vertriest
2014 International Journal of Integrated Care  
Given that integrated care includes many different aspects, a study of how integration of care can be best be developed calls for an equally integrated research approach. The CORTEXS research project on integrated care in Flanders (Belgium) has developed a research design that takes (part of) this multi-facetedness and complexity into account. The research design involves multiple disciplines, levels of analysis, and methods. (1) The multidisciplinary research team combines expertise in
more » ... xpertise in organization sciences (including sociology, management and social innovation) with proficiency in care-specific disciplines (including care quality and safety, medical law, health economics and patient participation). (2) Integrated care is studied from the micro-level of care recipients and their informal caregivers, over the meso-level of intra-and inter-organizational processes, to the macro-level of legal and financial frameworks. (3) At each level, the most appropriate research methods are applied, including document analysis, process mapping, network analysis, comparative case analysis and economic modeling. The research comprises five work packages (WPs), each aimed at a specific research question: (WP1) Which models of integrated care for chronic and long term care needs can be found in the literature, and how can they be used for the further development of integrated care in the Flemish context? (WP2) What are the organizational components of integrated care models, and which options do they offer for supporting patient interests and quality of work for the health professionals? (WP3) What are the inter-organizational components of integrated care models, and how can networked coordination be realized? (WP4) What are the legal and financial conditions for implementing integrated care models in Flanders? (WP5) What is the performance of integrated care models in terms of quality and safety, and in terms of efficiency? It should be noted that each WP involves contributions from the various disciplines. The research has an embedded case design, involving multiple units of analysis. Since the WPs study integrated care at different levels, each WP defines and selects its own units of analysis (i.e. cases), yet always within the framework of larger, commonly defined cases. These main cases are defined as a cluster of care needs of a group of care recipients. Their care needs are chronic or long term in nature, and the selected group encompasses care recipients with complex, comorbid conditions, who have both health and social care needs. Information-oriented sampling is used to select four main cases. The cluster of care needs of Multiple Sclerosis (MS) patients has been selected as the pilot case. MS diagnosis is made at ever earlier age, involving additional kinds of care
doi:10.5334/ijic.1886 fatcat:r2nem4jh3fcvnayttjt35is47m