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Tackling the problem of regulatory pressure in Dutch elderly care: The need for recoupling to establish functional rules

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  • van de Bovenkamp, Hester M.
  • Stoopendaal, Annemiek
  • Bochove, Marianne van
  • Bal, Roland

Abstract

Regulatory pressure is widely recognized as a problem in healthcare. At first sight the solution seems simple: discard rules and give caregivers more resources to provide personalized care. Based on qualitative research in four elderly care organizations in the Netherlands, this paper shows that regulatory pressure is a persistent problem that cannot be solved on an individual level, as it results from a disconnect between the work of different actors in the healthcare system. Drawing on concepts from Organization Studies, the paper shows that the work of caregivers, healthcare managers and external actors is often decoupled. Caregivers experience regulatory pressure when the origin and function of rules are unclear. The studied care organizations are experimenting with rules, reconsidering and creating functional rules. They do so by stimulating reflection among actors in the healthcare system, thereby recoupling their work. The findings suggest that recoupling can be achieved by creating comfort zones, focusing on stimulating debate between stakeholders on the functionality and origin of rules and aligning ideas about good quality care, the role different actors can play and the rules that are needed to accommodate this.

Suggested Citation

  • van de Bovenkamp, Hester M. & Stoopendaal, Annemiek & Bochove, Marianne van & Bal, Roland, 2020. "Tackling the problem of regulatory pressure in Dutch elderly care: The need for recoupling to establish functional rules," Health Policy, Elsevier, vol. 124(3), pages 275-281.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:3:p:275-281
    DOI: 10.1016/j.healthpol.2019.12.017
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    References listed on IDEAS

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    4. Alders, Peter & Costa-Font, Joan & de Klerk, Mirjam & Frank, Richard, 2015. "What is the impact of policy differences on nursing home utilization? The cases of Germany and the Netherlands," Health Policy, Elsevier, vol. 119(6), pages 814-820.
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    1. van de Bovenkamp, Hester & van Pijkeren, Nienke & Ree, Eline & Aase, Ingunn & Johannessen, Terese & Vollaard, Hans & Wallenburg, Iris & Bal, Roland & Wiig, Siri, 2023. "Creativity at the margins: A cross-country case study on how Dutch and Norwegian peripheries address challenges to quality work in care for older persons," Health Policy, Elsevier, vol. 127(C), pages 66-73.

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