Figure 1
These three key policy initiatives guided our stakeholder interviews.
Table 1
Organizations and participating stakeholders.
| ORGANIZATIONS | |
|---|---|
| Regulatory stakeholders (policymakers & public administrators) | |
| Federal Public Service of Health (FOD) | Flemish Cabinet |
| Association of Flemish Cities and Municipalities (VVSG) | Flemish Agency of Care and Health (VAZG) |
| Finance stakeholders | |
| National Institute of Health & Disability Insurance (NIHDI) (3 interviews) | Christian Health Fund (CM) |
| Joint College of Sickness Funds (NIC) | Socialist Sickness Fund |
| Provider organizations (labour – professional associations) | |
| Medical Association of GPs (Domus Medica, DM) | Flemish Association of Dieticians |
| Belgian Association of Doctors Syndicates (BVAS) | Association of Diabetes Nurses |
| Medical Association of GPs and Specialists (ASGB) | Flemish Association of Independent Nurses (VBZV) |
| General Pharmaceutical Association (APB) | Network of Homecare Nurses (Zorggezind) |
| Network of Hospitals (ICURO) | Association of Home Nursing (WGK) |
| User and patient groups | |
| Flemish Patient Platform (VPP) | Flemish Diabetes Association (Diabetes liga) |
| Scientific stakeholders | |
| Federal Knowledge Centre for Health Care (KCE) | Academia/Medical universities (2 interviews) |
Figure 2
Relationships and linkages between macro-level factors.
Appendix 1
Code tree.
| APPENDIX |
|---|
| Administration |
| Consultation |
| E-health |
| Data sharing |
| Fragmentation within e-health |
| Market vs central EHR offered by government |
| Mindset |
| Only for medical |
| Privacy |
| Financing |
| Budget |
| Costs for patients |
| Financing system |
| Capitation system |
| Fee for service |
| Mixed financing system |
| Pay for quality |
| Silo model |
| Supply vs demand-oriented system |
| Maisons médicales |
| Mentality to healthcare |
| Belief or unbelief in need for change |
| Change management |
| Different understanding integrated care |
| Self-interest |
| Participation & Collaboration |
| Equal partners |
| Fragmented field (meso-macro players) |
| Integration through care cotinuum |
| Knowing each other |
| LMN |
| Mentality to participate or collaborate |
| Role of the patient or citizen |
| Vertical integration |
| Voluntarism |
| Political system – reality |
| Competency split between governments |
| Governance |
| Decision process |
| Equity (vulnerable groups) |
| Interactive governance |
| Intersectoral approach |
| Multi-level governance |
| Transparency |
| Leadership |
| Local authorities |
| Policy process |
| Political preference |
| Political will (political support) |
| Time needed for research vs fast results wanted |
| Population health approach |
| Autonomy of HCW |
| Big data for population health approach |
| Kaiser permanente |
| Prevention |
| Primary care |
| Protocol care |
| Tailored interventions for patient |
| Task delegation |
| Training & education |