Belgium’s Healthcare System: The Way Forward to Address the Challenges of the 21st Century Comment on "Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study"

Abstract

In this paper we have tried, starting from the results of an analysis of the functioning of integrated care in the Belgian Health System by Martens et al, to design a strategy that could contribute to better addressing the challenges of the 21st century in Belgium. We proposed health system changes at the macro-, meso- and micro-level. We focused on health policy development and organization of care, emphasizing the importance of a shift from a hospital-centric towards a primary care based approach. Special attention was paid to the need for institutional reforms, in order to facilitate the further development of interprofessional integrated care, that focuses on the achievement of the life-goals of a person.

Integration of Chronic Care in a Fragmented Healthcare System Comment on "Integration or Fragmentation of Health Care? Examining Policies and Politics in a Belgian Case Study"

“… 1 De Maeseneer et al and Gray shared their commentaries on this paper with suggestions on how changes at a macro-, meso- and micro-level could support future integration of care in Belgium. 2 , 3 In addition, we would like to add our perspective, as researchers in the field of integrated heart failure (HF) care and active primary healthcare professionals. Our itinerary exposes the consequences of policy decisions on the very slow adaptation of innovative practices in healthcare and how a Learning Healthcare Network (LHCN) can be a means to deal with these macro-level barriers.…”

“… 5 In order to achieve this, we require new forms of institutional structures or leadership. 2 , 3 In addition, there is need to develop new roles and competencies. 6 - 8 For example, let’s have a closer look at patient education and empowerment.…”

“… 1 Indeed, this restructuring proved to be effective in enhancing multidisciplinary and transmural collaboration to tackle the coronavirus disease 2019 (COVID-19) pandemic. 2 However, it remains a challenge to engage individual health professionals operating within the primary care zones and to gain their full support for collaborative initiatives to make the population healthy. It is therefore important to solicit their perspectives as well, and assess which form of collaboration works best.…”

“… 6 However, long-term funding and ICT that promotes collaboration is missed. The latter was one of the main barriers reported by every project in the network underlining the need for an ‘interprofessional integrated goal-oriented electronic health record.’ 2 , 6 , 8 …”

The Tale of Nine Belgian Health Ministers and a Multi-level Fragmented Governance System: Six Guiding Principles to Improve Integrated Care, Responsiveness, Resilience and Equity; A Response to the Recent Commentaries

“…1 In five commentaries, academics, stakeholder representatives and frontline practitioners provided a kaleidoscopic view on the barriers hampering policy initiatives on IC. [2][3][4][5][6] We first comment on the commentaries before taking a step back from the subject of IC and proposing guiding principles towards defragmenting the Belgian health system.…”