Lorant Vincent, Grard Adeline, Nicaise Pablo
Institute of Health and Society, Université Catholique de Louvain, B1.30.15.05 Clos Chapelle-Aux-Champs, 1200, Brussels, Belgium.
Community Ment Health J. 2016 Apr;52(3):343-52. doi: 10.1007/s10597-015-9932-y. Epub 2015 Sep 2.
Belgium has recently reformed its mental health care delivery system with the goals to strengthen the community-based supply of care, care integration, and the social rehabilitation of users and to reduce the resort to hospitals. We assessed whether these different reform goals were endorsed by stakeholders. One-hundred and twenty-two stakeholders ranked, online, eighteen goals of the reform according to their priorities. Stakeholders supported the goals of social rehabilitation of users and community care but were reluctant to reduce the resort to hospitals. Stakeholders were averse to changes in treatment processes, particularly in relation to the reduction of the resort to hospitals and mechanisms for more care integration. Goals heterogeneity and discrepancies between stakeholders' perspectives and policy priorities are likely to produce an uneven implementation of the reform process and, hence, reduce its capacity to achieve the social rehabilitation of users.
比利时最近对其精神卫生保健服务体系进行了改革，目标是加强基于社区的护理供应、护理整合以及服务对象的社会康复，并减少对医院的依赖。我们评估了这些不同的改革目标是否得到了利益相关者的认可。122名利益相关者在网上根据优先级对改革的18项目标进行了排序。利益相关者支持服务对象社会康复和社区护理的目标，但不愿减少对医院的依赖。利益相关者反对治疗过程中的变革，尤其是减少对医院的依赖以及更多护理整合机制方面的变革。利益相关者观点与政策优先事项之间的目标异质性和差异可能会导致改革进程实施不均衡，从而降低其实现服务对象社会康复的能力。
