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      Promoting Integrated Care through a Global Treatment Budget : A Qualitative Study in German Mental Health Care using Rogers’ Diffusion of Innovation Theory

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          Abstract

          Introduction:

          Since 2003, as a means of enabling integrated care the German mental health care system has offered the innovative option of agreeing a Global Treatment Budget (GTB, also known as a regional psychiatric budget or innovative flexible and integrative forms of treatment FIT) with health insurers and regional care providers across sectors. Despite promoting legal frameworks and positive evidence on improving quality of patient care, this model has not spread widely. The aim of this study is to identify inhibiting and facilitating factors for the innovation diffusion.

          Theory and methods:

          We conducted expert interviews with 19 actors from nine German regions involved in GTBs, using a self-developed questionnaire based on Rogers’ theory on innovation diffusion extended by the innovation system approach. Interviews were analysed applying qualitative content analysis. Code categories were built deductively operationalising Rogers’ theory and inductively from the data generated.

          Results:

          Observability of the innovation was perceived as good, but trialability, reversibility, compatibility with regular care structures as low, and thus the perceived risks of adoption as high. Complexity up to implementation is high, caused by numerous individuals and stakeholder groups involved. Diffusion took place in environments of strong individuals with venturesomeness, opinion leadership, and informal networking. As favourable framework conditions the monopoly and non-profit position of hospitals in well-defined care regions were identified.

          Discussion and Conclusions:

          Diffusion of integrated care could be accelerated by dissolving the multi-actor constellation, changing the communication strategy, and adapting the legal framework.

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          Most cited references49

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          A New Product Growth for Model Consumer Durables

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                Author and article information

                Contributors
                Journal
                Int J Integr Care
                Int J Integr Care
                1568-4156
                International Journal of Integrated Care
                Ubiquity Press
                1568-4156
                30 November 2021
                Oct-Dec 2021
                : 21
                : 4
                : 27
                Affiliations
                [1 ]Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany
                [2 ]Department of Information Systems, School of Business and Economics – Freie Universität Berlin, Garystr. 21, 14195 Berlin, Germany
                [3 ]Professorship of Innovation Management, School of Business and Economics – Freie Universität Berlin, Thielallee 73, 14195 Berlin, Germany
                Author notes
                CORRESPONDING AUTHOR: Dr. med. Anne Berghöfer Institute of Social Medicine, Epidemiology and Health Economics, Charité – Universitätsmedizin Berlin, Luisenstr. 57, 10117 Berlin, Germany anne.berghoefer@ 123456charite.de
                Author information
                https://orcid.org/0000-0003-4756-4252
                https://orcid.org/0000-0003-0383-3991
                https://orcid.org/0000-0002-7897-6500
                Article
                10.5334/ijic.5940
                8663745
                34963756
                f0a4d9a7-06c6-4c5a-a524-9b4e9fa97dbe
                Copyright: © 2021 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

                History
                : 05 March 2021
                : 13 November 2021
                Categories
                Research and Theory

                Health & Social care
                global treatment budget,flexible,integrated treatment models fit,cross-sectoral care,rogers’ innovation diffusion theory,qualitative study,qualitative content analysis

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