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Papers by Mirella Minkman

International Journal of Integrated Care, 2022

International Journal of Integrated Care, Nov 23, 2018

Human-Computer Interaction, Aug 9, 2023

BMC Medical Informatics and Decision Making, Mar 1, 2023

International Journal of Integrated Care, Nov 4, 2022

International Journal of Integrated Care, 2022

The world is in a hurry, but change is slow. Agendas are fully booked, labour markets are tense, ... more The world is in a hurry, but change is slow. Agendas are fully booked, labour markets are tense, and we seem already (too) late to alter the course of climate change. We have faced a crisis situation which has led us towards working on more ‘pandemic preparedness’. In many countries, evaluation programs try to draw lessons from the pandemic and its impact, yet at the same time try to speed up research activities, the provision of expert advice, and policy making in an attempt to reduce health damage and stabilize tensions in societies through rapid decision-making. However, these decisions themselves are eventually followed up by deep discussions about what the ‘right’ directions should be. These directions are deeply debated given how people’s perspectives for ‘what is right’ differ significantly. As we have learned in dealing with the pandemic, solutions are not simply healthbased, but must be addressed from a wider spectrum of responses to deal with the ‘wicked problem’ [1]. Integrated care and services are an important component for addressing such complex problems since multiple stakeholders, independent organisations, (conflicting) regulations and non-aligned values all play a role in making a collective response harder. Policymakers, practitioners and researchers around the globe have for many years tried to ‘solve’ fragmentation and increase coherence in approaches that support better health and healthcare. For example, caring communities, citizens as partners, and intensifying prevention and primary care-based services are frequently mentioned as ingredients for future health systems. Countries should work on overarching solutions that try to keep a broad perspective, as piecemeal reforms addressing only one aspect of the system at a time have been proven to fall short of the sustainable change necessary to address the complex problems we face today. The recent policy papers in IJIC about the last decade of integrated care in 19 countries including Belgium, Italy, the UK, Switzerland, Canada, the USA and so on, describe examples of these long term efforts. Yet, these policy experiences are often characterized by temporary impulses for ‘quick fixes’ rather than addressing broad spectrum interventions on mixed levels (local, regional, national) and, potentially as a result, in general have achieved mixed results [2–6]. Schroeder and Cutler recently highlighted the complexity of financial reforms needed to incentivize integrated care [7]. It is not only the healthcare system that is fragmentated, also other system issues like legislation or financial mechanisms are fragmented in itself. This increases the complexity for alignment and transformation even more.

Tijdschrift Voor Gerontologie En Geriatrie, Jun 1, 2015

International Journal of Integrated Care, 2020

International Journal of Integrated Care, Apr 8, 2022

International Journal of Integrated Care, Sep 20, 2021

Background: To help enhance the quality of integrated stroke care delivery, regional stroke servi... more Background: To help enhance the quality of integrated stroke care delivery, regional stroke services networks in the Netherlands participated in a self-assessment study in 2012, 2015 and 2019. Methods: Coordinators of the regional stroke services networks filled out an online self-assessment questionnaire in 2012, 2015 and 2019. The questionnaire, which was based on the Development Model for Integrated Care, consisted of 97 questions in nine clusters (themes). Cluster scores were calculated as proportions of the activities implemented. Associations between clusters and features of stroke services were assessed by regression analysis. Results: The response rate varied from 93.1% (2012) to 85.5% (2019). Over the years, the regional stroke services networks increased in ‘size’: the median number of organisations involved and the volume of patients per network increased (7 and 499 in 2019, compared to 5 and 364 in 2012). At the same time, fewer coordinators were appointed for more than 1 day a week in 2019 (35.1%) compared to 2012 (45.9%). Between 2012 and 2019, there were statistically significantly more elements implemented in four out of nine clusters: ‘Transparent entrepreneurship’ (MD = 18.0% F(1) = 10.693, p = 0.001), ‘Roles and tasks’ (MD = 14.0% F(1) = 9.255, p = 0.003), ‘Patient-centeredness’ (MD = 12.9% F(1) = 9.255, p = 0.003), and ‘Commitment’ (MD = 11.2%, F(1) = 4.982, p = 0.028). A statistically significant positive correlation was found for all clusters between implementation of activities and age of the network. In addition, the number of involved organisations is associated with better execution of implemented activities for ‘Transparent entrepreneurship’, ‘Result-focused learning’ and ‘Quality of care’. Conversely, there are small but negative associations between the volume of patients and implementation rates for ‘Interprofessional teamwork’ and ‘Patient-centredness’. Conclusion: This long-term analyses of stroke service development in the Netherlands, showed that between 2012 and 2019, integrated care activities within the regional stroke networks increased. Experience in collaboration between organisations within a network benefits the uptake of integrated care activities.