Horizontal collaborative purchasing (HCP) has often been cited as a way for hospitals to address the challenges of the rising healthcare costs. However, hospitals do not seem to utilize horizontal collaborative purchasing on any large scale, and recent initiatives have had mixed results. Focusing on Dutch hospitals, in this paper we present major impediments for collaborative purchasing, resulting in a first component of our proposed electronic horizontal collaborative purchasing model for hospitals; as a second component it contains a collaborative purchasing typology. A first validation round with hospital purchasing professionals, described separately in Kusters and Versendaal (2011), confirmed four applicable purchasing types and fourteen salient collaborative purchasing impediments. The model is operationalized by including possible information technology (IT) solutions that address the specific fourteen impediments. This model is validated through methodological triangulation of four different validation techniques. We conclude that IT has the potential to support, or overcome, the impediments of HCP. The validation also reveals the need to distinguish between more processrelated, as opposed to social-related, obstacles; the immediate potential for IT solutions is greater for the process-related impediments. Ultimately, we conclude that the collaborative epurchasing model (e-HCP) and implementation roadmap can be used by healthcare consortia, branche organizations, partnering healthcare institutes and multi-site healthcare institutes as a means to help identifying strategies to initiate, manage and evaluate collaborative purchasing practices
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Senior co-housing communities offer an in-between solution for older people who do not want to live in an institutional setting but prefer the company of their age peers. Residents of co-housing communities live in their own apartments but undertake activities together and support one another. This paper adds to the literature by scrutinizing the benefits and drawbacks of senior co-housing, with special focus on the forms and limits of social support and the implications for the experience of loneliness. Qualitative fieldwork was conducted in eight co-housing communities in the Netherlands, consisting of document analysis, interviews, focus groups, and observations. The research shows that co-housing communities offer social contacts, social control, and instrumental and emotional support. Residents set boundaries regarding the frequency and intensity of support. The provided support partly relieves residents’ adult children from caregiving duties but does not substitute formal and informal care. Due to their access to contacts and support, few residents experience social loneliness. Co-housing communities can potentially also alleviate emotional loneliness, but currently, this happens to a limited degree. The paper concludes with practical recommendations for enhancing the benefits and reducing the drawbacks of senior co-housing. Original article at MDPI; DOI: https://doi.org/10.3390/ijerph16193776
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This paper investigates the relationship between self-build housing and the wider planning and housing regime. Although there is growing policy and academic attention to self-build housing, there is a lack of understanding of the institutional and regulatory conditions shaping the prospects of such housing provision. This paper takes the case of The Netherlands and scrutinizes how institutional dynamics over time have made lower and middle residents dependent on densely organized consortia of municipalities, housing associations and developers. These norms of land development appear to be at odds with the logic of self-building. Through exploring evidence in a pilot study of a municipal self-building scheme in Almere, the authors suggest that making self-building the cornerstone of a resident-led land development strategy, also for low- and middle-incomes, implies a reconfiguration of the actors’ positions in housing provision. This entails a commissioning role for residents in the institutional domain of social and commercial developers.
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