Decentralisations in the Dutch social care sector : researching approaches of municipal commissioning of social care on patient perceived quality of care and self-reliance

HEUZELS, L.H. (2017) Decentralisations in the Dutch social care sector : researching approaches of municipal commissioning of social care on patient perceived quality of care and self-reliance.

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Abstract:The goal of this thesis is to provide empirical evidence for the effects the different Dutch municipal approaches towards commissioning care have. The main research question is the following: “Does the approach of municipal commissioning of care influence quality of care and self-reliance of clients after the Dutch social domain decentralizations of 2015?” Municipal commissioning of care is conceptualized into three components: five commissioning archetypes, three financing- and contract types. Each of these approaches have mechanisms that potentially influences behaviour of care providers. Principal-agent- and service-triad theories form the background of these incentives. Outcome variables consist of client perceived assessments of quality of care and self-reliance. A quantitative analysis, using ANOVA, T-Tests and a Difference-in-Differences-analysis are conducted in order to see whether or not the choice for a certain commissioning approach affects the client perceived quality of care and self-reliance. Analysing the effect on quality of care, on first hand it appears that influence of the commissioning approach is very small. The same pattern is visible when looking at financing and contract types. However, when looking at the assessment of quality of care over time the commissioning effect surfaces. The new, more innovative approaches were structurally graded lower by especially relatives of clients. The lower assessment of these new approaches may perhaps be explained by reluctance towards changes in care provision by both groups. Looking at self-reliance Wijkgericht Contracteren and the corresponding financing and contracting models outperform the others. This was not expected based on service-triad theory and the models incentives.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:70 social sciences in general, 88 social and public administration
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/72154
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