PhD defence C.H.E. (Lieke) Reinhoudt-den Boer

Below is a brief summary about the dissertation:

Individuals dealing with a combination of (psycho)social and health problems (often referred to as people with multiple problems) often find themselves outside the scope of traditional health and social care systems, despite a clear societal demand to provide them with the necessary care. A significant contributing factor to this issue is the mismatch between the design and organization of these care systems and the intricate, interrelated, and structural problems faced by many individuals with multiple challenges. 

In recent years, the landscape of care for individuals with multiple challenges has transformed under the influence of welfare state reforms. Two fundamental principles of these reforms are co-production and integrated care. Co-production entails not merely delivering care to citizens but also expecting them to mobilize their own resources. Integrated care revolves around organizing care according to individuals' needs in a coordinated fashion. 

While co-production and integrated care hold clear political, practical, and theoretical appeal, questions persist regarding the extent to which they will enhance services for individuals with multiple problems. This thesis seeks to address the pressing question of whether integrated care and co-production can improve care for individuals with multiple problems by voicing the concerns and perspectives of these individuals and their (in)formal caregivers. 

This thesis concludes that co-production and integrated care may not substantially enhance care for individuals with multiple problems, especially when implemented in alignment with the political ideals underpinning current welfare state reforms. It demonstrates that both integrated care and co-production require a nuanced approach before effectively meeting the needs of these individuals.