Zorginitiatieven als oplossing voor cultuurverschil in de zorg? Een onderzoek naar cultuurverschil tussen zorgprofessional en bestuurder en welke samenwerkingscondities hier van invloed op zijn

Abstract

Fueled by increasing costs and growing evidence of inefficiency in care, New Public Management (NPM) was introduced in health care. Where professional knowledge was dominant in the seventies, control and accounting along with business-like relationships between professionals and managers have dominated care since the eighties. It was considered to be an effective and democratic method for managing Dutch health care. Over the past few years, researchers in many countries have begun doubting the model’s suitability. Professionals claimed that performance-based reimbursement affects the professional autonomy and quality of care. Managers on the other hand said NPM is the only way in dealing with the rising costs and upcoming crisis. Collaboration is one of the solutions given in literature to cope with this contradiction.

As a reaction to this development civilians start their own healthcare institutions. In these citizens’ initiatives collaboration is a key element. Due to that two citizens’ initiatives in health care were taken as case studies in this research. Data was collected from eight interviews and 41 sources of content analyses and analyzed using deductive qualitative analysis. Results showed that the group professionals and the group managers have in general the same culture; results and intern oriented. The small culture differences between these groups were linked to a flat organization structure, informal contacts and a high amount of shared values.