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荷兰医疗保健改革:实用的人群健康管理与普洛特模型:一项评估荷兰六个地区意愿和准备情况的问卷调查及焦点小组研究

Reforming healthcare in the Netherlands: practical population health management and the Plot model: A questionnaire survey and focus group study to assess the willingness and readiness of six regions in the Netherlands.

作者信息

Minderhout Rosa Naomi, van Ede Annefrans Ftm, Voragen Leonie, Verheijen Carl, Vos Hedwig Mm, Numans Mattijs E, Stein K Viktoria, Bruijnzeels Marc A

机构信息

Department of Public Health and Primary Care/Health Campus The Hague, Leiden University Medical Centre, The Hague, The Netherlands.

HealthKic Foundation, facilitated by Noaber foundation, Menzis, Bernard van Leer Foundation, PGGM, All about Health and Ministry of Health, Wellbeing and Sports, The Netherlands.

出版信息

SAGE Open Med. 2023 Mar 17;11:20503121231160830. doi: 10.1177/20503121231160830. eCollection 2023.

Abstract

OBJECTIVE

As in many other countries, the Netherlands is facing challenges in the provision of healthcare to its population. To ensure the population remains in good health in coming decades, an integrative approach to the many factors that influence health and health outcomes is needed. Population health management is gaining interest as a strategic framework for systems change in healthcare organisations. Based on population health management, the Dutch HealthKIC has developed the 'Plot model', which takes a regional perspective. The aim of this study was to detail the extent to which six prospective regions in the Netherlands were ready and willing to implement population health management using the Plot model, guided by the Five Lenses Model.

METHODS

Using an exploratory focus group reporting study, we involved stakeholders from six regions in the Netherlands. Thematic analysis followed the five predesigned dimensions of a validated cooperation model.

RESULTS

The study uncovered the potential for realisation of model aims, as assessed by an expert team, regarding shared ambition, mutual gains, relationship dynamics, organisational dynamics and process management. The exploratory questionnaire suggested that organisational dynamics is the least integrated topic in all areas, followed by process management, a finding confirmed in focus groups.

CONCLUSION

The building themes of the Five Lenses Model all represent preconditions for the success of integration in the prospective regions. The present study showed that while some themes were reasonably represented in prospective regions, no region was satisfactory for all themes.

摘要

目的

与许多其他国家一样,荷兰在为其民众提供医疗保健方面面临挑战。为确保民众在未来几十年保持健康,需要对影响健康及健康结果的诸多因素采取综合方法。人口健康管理作为医疗保健组织系统变革的战略框架正日益受到关注。基于人口健康管理,荷兰健康创新中心(HealthKIC)开发了从区域视角出发的“规划模型”(Plot model)。本研究的目的是详细说明荷兰六个前瞻性区域在“五视角模型”的指导下,准备好并愿意使用“规划模型”实施人口健康管理的程度。

方法

通过一项探索性焦点小组报告研究,我们邀请了来自荷兰六个区域的利益相关者参与。主题分析遵循一个经过验证的合作模型的五个预先设计的维度。

结果

正如一个专家团队所评估的,该研究揭示了在共同抱负、互利共赢、关系动态、组织动态和流程管理方面实现模型目标的潜力。探索性问卷表明,组织动态是所有领域中整合程度最低的主题,其次是流程管理,这一发现也在焦点小组中得到了证实。

结论

“五视角模型”的构建主题均代表了前瞻性区域整合成功的先决条件。本研究表明,虽然一些主题在前瞻性区域有一定体现,但没有一个区域在所有主题方面都令人满意。

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