Facilitating and inhibiting factors affecting the Netherlands Heart Network

This paper investigates the experiences of stakeholders involved with the Netherlands Heart Network (NHN) and provides insights into the importance of the facilitating and inhibiting factors of the network. An essential feature of the NHN is that health insurers provided a subsidy to develop and carry out the activities of the network. However, the NHN does not have a value-based payment system.

We included stakeholders who played a role in designing, implementing, or evaluating the network, or were involved in any other aspect. They were asked to fill in an online questionnaire and rate the importance of 16 factors for the functioning of the NHN on a 5-point Likert scale and were asked to suggest additional factors. Data were analyzed using descriptive statistics and cluster analyses.

Adequate collaboration between general practitioner groups and hospitals, medical specialists and/or physicians actively involved, and transparency, communication, and trust between stakeholders were mentioned as the most important factors. One cluster of respondents highly evaluated the network because of the independence of the funding from the central organization.

Coordination, collaboration, transparency, communication, and trust were found to be essential for the success of the NHN’s value-driven network, related to the human, less tangible side of the network. As these elements are frequently found in value-based structures with a payment component, it may serve as a confirmation that more complex infrastructures (with a payment element) are affected by the same factors as simpler ones, such as the NHN.