Scaling up integrated care for chronic diseases : exploring perspectives on agency, processes, mechanisms and structures

Monika Martens

Research output: ThesisDoctoral dissertation - Doctoral dissertation

Abstract

This PhD started in 2019, embedded within the European-funded SCUBY project on facilitating scale-up of integrated care for chronic diseases in three contexts. It has now started to lead a life of its own, in this book, reflecting on agency, processes, mechanisms and structures required to scale-up. These four perspectives all support the aim of this thesis; to understand the scale-up of integrated care in diverse health systems. The role of policy dialogues, stakeholders, scale-up roadmap development and implementation and contextual processes pose central elements in this quest. Using case studies and qualitative research, we learn from scale-up efforts in a resource-constrained health system in a lower-middle-income country (Cambodia); a centrally steered health system in a high-income country (Slovenia); and a publicly-funded, highly privatised health care system in a high-income country (Belgium). We showcase and argue that both policy and (realist or theory-driven) implementation research are needed to study and close the gap between science and politics to scale-up. In summary, this thesis highlights the inherent complexity, ambiguity, uncertainty, and power dynamics involved in scaling up integrated care, emphasizing the need for collaborative, adaptive approaches that acknowledge diverse perspectives and meaningfully engage stakeholders in the problem-solving process.
Translated title of the contributionOpschalen van geïntegreerde zorg voor chronische ziektes: Onderzoek over de rol van actoren, processen, mechanismes en structuren
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • University of Antwerp
Supervisors/Advisors
  • Van Damme, Wim, Supervisor
  • Van Belle, Sara, Supervisor
  • van Olmen, Josefien, Supervisor, External person
  • Wouters, Edwin, Supervisor, External person
Award date14-Jan-2025
Place of PublicationAntwerpen
Publisher
DOIs
Publication statusPublished - 14-Jan-2025

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