The influence of institutions and culture on health policies :  different approaches to integrated care in England and the Netherlands 

 -  2002 
<br/><br/> The concept of integrated care has assumed growing importance on the policy agendas both in England and The Netherlands and elsewhere. It is characterized as health and health care-related social care needed by patients with muti-faceted needs. This article compares policy approaches to integrated care in England and The Netherlands. Differing political strategies and conditions for integrated care correspond to the dissimilarities in the institutional structure and culture of their health care systems. Health care systems are understood as specific national and historical configurations. We review the last decade's relevant policy processes, using the concepts of hierarchcial steering, thus creating tight newtwork structures for integrated care on the local level. The Netherlands, with its health care system in a public-private mix, has set ncentives for voluntary, loosely coupled and partly market-driven cooperation on the local level. Implications for success or failure are mixed in both configurations. Policy recommendations have to be tailored to each system's characteristics