Healthier living with one vision and one budget

Participants of the International Conference on Integrated Care (ICIC) visited Oss during one of the offered site visits in May 2018. Local residents and organizations create new solutions together in the district of Ruwaard, helping themselves and each other. A perfect example of integrated care.

Positive health
Since the beginning of 2016, the aim of ‘Proeftuin Ruwaard’ (Ruwaard pilot) is to create a vital neighborhood with one vision and one healthcare budget, where local residents experience a better and more positive health at lower costs. This means, among other things, that the different care and welfare organizations will no longer be paid separately for each separate intervention and act. Instead, there is a lump sum budget for the entire neighborhood that finances the deployment of professionals.

Question from local residents
Individual and collective cases are dealt with. In this method a multidisciplinary team, tailor-made according to the local resident’s needs, decides on the best solution together with the resident. An example of a collective case is ‘Ons huis in de wijk’ (Our house in the neighborhood).

Anton Mulders addresses the international visitors in ‘Ons huis in de wijk’: ‘Residents of Ruwaard come here every day doing everything they want actually, without paying any money.’ Mulders is one of the initiators of ‘Ons huis in de wijk’. ‘There is a group of people with diabetes who meet here for a walk together. There is a workshop where people can do odd jobs, there is gardening, there is cooking and there is even a gospel choir. But for example, there is also a gentleman who visits every day just sitting and reading, never saying a word. Everything is run without professionals. This building is not owned by one particular organization. It is the property of the municipality who opened it for everyone who wants to work or meet people.

Contact with professionals
Apart from being a meeting place, the neighbourhood house is also a place where residents can connect with the right organizations. Program manager Susanne Smits from Robuust: ‘Professionals working in the neighborhood now are regularly working in the neighbourhood house. This is great for residents, because they connect easily with the professionals in this way. They help residents to set up activities if necessary or bring them in contact with other residents or an organization.’

Healthier living
‘The first studies show that the neighborhood’s home really contributes to a healthier life for people. Participants themselves indicate that they have more social contacts, feel better and even feel more active, due to their participation in ‘Ons huis in de Wijk’. At this moment, we are investigating whether these results lead to people needing less visits to the general practitioner or social worker for example. We think that it does.’

Lower costs
The latter also helps with the aim of ‘Proeftuin Ruwaard’, to be able to help more people for the same care budget. Smits: ‘If we look at social revenues, we see that our multidisciplinary approach based on the 3 questions “I want”, “I can” and “I need”, leads to lower social costs per case and a higher perceived well-being of the neighborhood resident involved. We measure this by randomly identifying individual cases, and figuring out what the costs would have been before, and what the actual costs are in this new solutions. ‘

Population-related financing
The foreign delegation is impressed. A participant says: ‘It is great that people in Oss work on the basis of what residents need. They stick out their necks to make this possible by financing in advance on a population basis. They say: “Not possible? We do it anyway!”’

Lian Stouthard is a Junior Researcher at Vilans