Department of Socio-Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
Health Res Policy Syst. 2023 Nov 28;21(1):125. doi: 10.1186/s12961-023-01077-4.
Although the promise of integrated neighborhood approaches, including the essential roles of communities and collaboration between the medical and social domains, has been widely acknowledged, the realization of such approaches in practice often remains difficult. To gain insight into the development of integrated neighborhood approaches, this case study describes the experiences of stakeholders involved in such an approach for health promotion and prevention in Rotterdam.
Interviews with 18 stakeholders (including health and social care professionals, health insurance employees, and policymakers) were conducted, and stakeholders' statements were analyzed thematically.
The results reveal a lack of alignment among the professional, organizational, and system levels. Elements needed for collaboration between health and social care professionals are not supported at the organizational and system levels. The lack of integration at the policy and organizational levels encourages competition and self-interest instead of stimulating collaboration.
Intersectoral collaboration and coordination must take place not only between professionals, but also at the organizational and policy levels. As long as integration at the organizational and system levels is lacking, professionals' ability to collaborate and provide coordinated support to neighborhood residents will be compromised.
尽管综合邻里方法（包括社区的基本作用和医疗与社会领域之间的合作）的前景已得到广泛认可，但在实践中实现这种方法往往仍然具有挑战性。为了深入了解综合邻里方法的发展，本案例研究描述了参与鹿特丹健康促进和预防综合邻里方法的利益相关者的经验。
对 18 名利益相关者（包括卫生和社会保健专业人员、健康保险公司员工和政策制定者）进行了访谈，并对利益相关者的陈述进行了主题分析。
研究结果显示，专业、组织和系统层面之间缺乏一致性。卫生和社会保健专业人员之间合作所需的要素在组织和系统层面上得不到支持。政策和组织层面缺乏整合鼓励竞争和自身利益，而不是刺激合作。
部门间的协作和协调不仅要在专业人员之间进行，还要在组织和政策层面进行。只要组织和系统层面缺乏整合，专业人员合作和为邻里居民提供协调支持的能力就会受到影响。
