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Striving for community-based integrated care in an urbanised area: lessons learned from 30 years of experience with a health partnership in Amsterdam Southeast.
Plochg, T., Hoogedoorn, N., Delnoij, D.M.J., Klazinga, N.S. Striving for community-based integrated care in an urbanised area: lessons learned from 30 years of experience with a health partnership in Amsterdam Southeast. European Journal of Public Health: 2004, 14(4 Suppl.) 42. Abstract. 12 th Annual EUPHA meeting: Urbanisation and health: new challenges in health promotion and prevention in Oslo, Norway, 7-9 october 2004.
Background: Off 1966 the city of Amsterdam expanded towards the Southeast. New districts were built
for approximately 120,000 residents. Soon problems occurred, as the local government failed to plan
(public) health care services. Health care professionals and residents attempted to address these
problems by influencing health care policy. This resulted in the foundation of a community-based
health partnership in 1973. The health partnership still exists today. It survived several crises,
resulting from major changes in the community and (public) health policy. Aim: To describe the
development and transformation of a communitybased health partnership in Amsterdam Southeast over a
period of 30 years. Methods: Multiple methods and sources were used to collect data: a) 24
semi-structured interviews with old key players and current
representatives of the providers participating in the partnership as well as representatives of
external stakeholders. b) Attending meetings of the health partnership. c) Document analyses of
meeting minutes, relevant policy papers, year reports and other documents. Results: a) The strategic
orientation of the partnership changed over time from establishing new structures towards
integrating care processes towards maintaining collaboration and setting up new health services for
marginalized residents. These periods coincide with the shifting focus of Dutch health policy. b)
The district has become a multicultural and deprived area in one decade. As a consequence, the
original proactive community participation has disappeared. Despite initiatives to revive
participation, existing patient associations lack the organisational ability and the
support of the community to actively participate in the partnership. c) Reported successes are the
establishment of 5 primary care centres, one regional ambulatory psychiatric organisation, regional
case management of chronically and elderly patients, and regional disease management programmes for
stroke and diabetes. Conclusions: The community-based health partnership is sustainable, as it
continuously adapts itself to the changing context of health policy and community needs. The
strategic orientation of the partnership shifted from a public health perspective to a health
services perspective. Nowadays the pendulum seems to swing back. The partnership explores
collaborative initiatives to set up health services for marginalized residents. The 30 years of
experience provide a good example of the dynamics of community-based integrated care in an urbanised
area.
for approximately 120,000 residents. Soon problems occurred, as the local government failed to plan
(public) health care services. Health care professionals and residents attempted to address these
problems by influencing health care policy. This resulted in the foundation of a community-based
health partnership in 1973. The health partnership still exists today. It survived several crises,
resulting from major changes in the community and (public) health policy. Aim: To describe the
development and transformation of a communitybased health partnership in Amsterdam Southeast over a
period of 30 years. Methods: Multiple methods and sources were used to collect data: a) 24
semi-structured interviews with old key players and current
representatives of the providers participating in the partnership as well as representatives of
external stakeholders. b) Attending meetings of the health partnership. c) Document analyses of
meeting minutes, relevant policy papers, year reports and other documents. Results: a) The strategic
orientation of the partnership changed over time from establishing new structures towards
integrating care processes towards maintaining collaboration and setting up new health services for
marginalized residents. These periods coincide with the shifting focus of Dutch health policy. b)
The district has become a multicultural and deprived area in one decade. As a consequence, the
original proactive community participation has disappeared. Despite initiatives to revive
participation, existing patient associations lack the organisational ability and the
support of the community to actively participate in the partnership. c) Reported successes are the
establishment of 5 primary care centres, one regional ambulatory psychiatric organisation, regional
case management of chronically and elderly patients, and regional disease management programmes for
stroke and diabetes. Conclusions: The community-based health partnership is sustainable, as it
continuously adapts itself to the changing context of health policy and community needs. The
strategic orientation of the partnership shifted from a public health perspective to a health
services perspective. Nowadays the pendulum seems to swing back. The partnership explores
collaborative initiatives to set up health services for marginalized residents. The 30 years of
experience provide a good example of the dynamics of community-based integrated care in an urbanised
area.
Background: Off 1966 the city of Amsterdam expanded towards the Southeast. New districts were built
for approximately 120,000 residents. Soon problems occurred, as the local government failed to plan
(public) health care services. Health care professionals and residents attempted to address these
problems by influencing health care policy. This resulted in the foundation of a community-based
health partnership in 1973. The health partnership still exists today. It survived several crises,
resulting from major changes in the community and (public) health policy. Aim: To describe the
development and transformation of a communitybased health partnership in Amsterdam Southeast over a
period of 30 years. Methods: Multiple methods and sources were used to collect data: a) 24
semi-structured interviews with old key players and current
representatives of the providers participating in the partnership as well as representatives of
external stakeholders. b) Attending meetings of the health partnership. c) Document analyses of
meeting minutes, relevant policy papers, year reports and other documents. Results: a) The strategic
orientation of the partnership changed over time from establishing new structures towards
integrating care processes towards maintaining collaboration and setting up new health services for
marginalized residents. These periods coincide with the shifting focus of Dutch health policy. b)
The district has become a multicultural and deprived area in one decade. As a consequence, the
original proactive community participation has disappeared. Despite initiatives to revive
participation, existing patient associations lack the organisational ability and the
support of the community to actively participate in the partnership. c) Reported successes are the
establishment of 5 primary care centres, one regional ambulatory psychiatric organisation, regional
case management of chronically and elderly patients, and regional disease management programmes for
stroke and diabetes. Conclusions: The community-based health partnership is sustainable, as it
continuously adapts itself to the changing context of health policy and community needs. The
strategic orientation of the partnership shifted from a public health perspective to a health
services perspective. Nowadays the pendulum seems to swing back. The partnership explores
collaborative initiatives to set up health services for marginalized residents. The 30 years of
experience provide a good example of the dynamics of community-based integrated care in an urbanised
area.
for approximately 120,000 residents. Soon problems occurred, as the local government failed to plan
(public) health care services. Health care professionals and residents attempted to address these
problems by influencing health care policy. This resulted in the foundation of a community-based
health partnership in 1973. The health partnership still exists today. It survived several crises,
resulting from major changes in the community and (public) health policy. Aim: To describe the
development and transformation of a communitybased health partnership in Amsterdam Southeast over a
period of 30 years. Methods: Multiple methods and sources were used to collect data: a) 24
semi-structured interviews with old key players and current
representatives of the providers participating in the partnership as well as representatives of
external stakeholders. b) Attending meetings of the health partnership. c) Document analyses of
meeting minutes, relevant policy papers, year reports and other documents. Results: a) The strategic
orientation of the partnership changed over time from establishing new structures towards
integrating care processes towards maintaining collaboration and setting up new health services for
marginalized residents. These periods coincide with the shifting focus of Dutch health policy. b)
The district has become a multicultural and deprived area in one decade. As a consequence, the
original proactive community participation has disappeared. Despite initiatives to revive
participation, existing patient associations lack the organisational ability and the
support of the community to actively participate in the partnership. c) Reported successes are the
establishment of 5 primary care centres, one regional ambulatory psychiatric organisation, regional
case management of chronically and elderly patients, and regional disease management programmes for
stroke and diabetes. Conclusions: The community-based health partnership is sustainable, as it
continuously adapts itself to the changing context of health policy and community needs. The
strategic orientation of the partnership shifted from a public health perspective to a health
services perspective. Nowadays the pendulum seems to swing back. The partnership explores
collaborative initiatives to set up health services for marginalized residents. The 30 years of
experience provide a good example of the dynamics of community-based integrated care in an urbanised
area.