Table 1
Legal framework, settings and care providers involved in early detection initiatives in The Netherlands.
| Legal basis | Setting | Service provider |
|---|---|---|
| Health Insurance Act: Objectives and budget set by central government. Executed by private healthcare insurance companies, which contract care providers. | General practice |
|
| Home care organization |
| |
| Hospital |
| |
| Social Support Act 2015: Objectives and budget set by central government. Executed by municipalities, which contract care providers. | Community service, Social care organization |
|
| No specific legal basis. | Senior citizens organization |
|
| Social network, neighbourhood facilities |
| |
| Public Health Act: Early detection of frail individuals does not take place, but a population approach is used in which municipalities focus on the broad population of the elderly in their municipality, for example by monitoring vulnerability, well-being and safety. | Municipality, public health services |
|
Table 2
Facilitators or barriers mentioned at the organizational, cultural/professional and contextual level.
| Groups | Commissioners | Service providers | Others | ||||
|---|---|---|---|---|---|---|---|
| Sub-groups | Municipalities policymakers (n = 9) | Representatives of health insurers (n = 3) | Managers from health and social care organizations (n = 9) | Health and social care professionals (n = 8) | Advisors from regional support centers (n = 4) | Academics (n = 2) | Representatives of organizations for older people (n = 2) |
| Organizational level | |||||||
| Knowing each other’s tasks and responsibilities | X | X | X | X | X | X | |
| Shared vision on early detection | X | X | X | X | |||
| Having seen the benefits of collaboration | X | X | X | X | X | ||
| Time available | X | X | X | X | X | X | |
| Shared patient information system | X | X | X | X | |||
| Organizational structure of municipalities | X | X | X | X | X | X | |
| Dealing with fragmented funding | X | X | X | ||||
| Cultural and/or professional | |||||||
| Knowledge on early detection approaches | X | X | X | X | |||
| Knowledge on privacy legislation | X | X | X | X | X | ||
| Trust | X | X | X | X | X | ||
| Leadership | X | X | X | X | X | X | X |
| Contextual | |||||||
| Continuity of funding for collaboration | X | X | X | X | X | ||
| Continuity of cooperation partners | X | X | X | X | X | ||