Enhancing self-care and access – The Dutch stepped care model to strategically organize public sexual health for young people

Filippo Zimbile , Silke David , Elmari Briedenhann , Lisette Schutte , Rik Crutzen
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Abstract

Public Sexual and Reproductive Health (SRH) services are traditionally provided face-to-face by Dutch Sexual Healthcare Clinics. High demand for these services led to the exploration of digital health to increase access and support self-care. However, the implementation was fragmented and uncoordinated. Therefore, the Stepped Care Model (SCM) was introduced to (1) organize coordination and cooperation between regional and national providers of public SRH-services for young people; (2) link digital services to clinical services and identify opportunities for new digital services; (3) increase the accessibility of SRH-services; and (4) stimulate self-care. This article describes the Dutch SCM and how digital health is integrated The process started by identifying key stakeholders and promoting collaboration followed by development and implementation of an unified national online platform to access comprehensive SRH services. The different levels of care of the existing services were categorized and overlap between services were inventoried. Based on ‘ideal client journeys’ for different sexual health themes, relevant services on different care levels were linked to each other and new opportunities for digital or combined digital-professional supported services were identified. It is explained how young people can gain easy access to increasingly specific and specialist services at the higher steps of the model via the online central portal with general information as a first step. The lessons learned highlight the importance of partnerships, coordination and a shared strategy leading to reduced fragmentation and increased accessibility of services and more self-care. The constraints of the Dutch SCM are related to restricted evaluation possibilities due to anonymized client data, limited target group involvement, complexity of digital service development along with possible resistance from health professionals. The SCM shows how efficiency in health systems can be achieved following the principle of economies of scale: more coordination and less fragmentation, leading to lower costs for development and implementation of digital services, availability and bundling of specialized technical and regulatory expertise and financial resources, ultimately leading to reduced waiting times and more self-care for young people.

加强自我保健和获取——荷兰阶梯式护理模式战略性地为年轻人组织公共性健康
公共性健康和生殖健康服务传统上由荷兰性保健诊所面对面提供。对这些服务的高需求促使人们探索数字健康,以增加获取和支持自我保健。然而,执行是分散和不协调的。因此,引入阶梯式护理模式(SCM)来(1)组织区域和国家青少年公共性健康和生殖健康服务提供者之间的协调与合作;(2)将数字服务与临床服务联系起来,识别新的数字服务机会;(3)提高性健康和生殖健康服务的可及性;(4)促进自我保健。本文介绍了荷兰的SCM以及如何集成数字健康。该过程首先确定关键利益相关者并促进协作,然后开发和实施统一的国家在线平台,以访问全面的性健康和生殖健康服务。对现有服务的不同护理级别进行了分类,并列出了服务之间的重叠部分。根据不同性健康主题的"理想客户旅程",将不同护理水平的相关服务相互联系起来,并确定了数字或数字-专业相结合的支持服务的新机会。它解释了年轻人如何通过在线中央门户网站,以一般信息为第一步,在模式的较高步骤上轻松获得日益具体和专业的服务。吸取的经验教训突出了伙伴关系、协调和共同战略的重要性,从而减少碎片化,增加服务的可及性和更多的自我保健。荷兰供应链管理的制约因素与以下因素有关:匿名客户数据限制了评估的可能性、目标群体参与有限、数字服务开发的复杂性以及卫生专业人员可能的抵制。《SCM》显示了如何按照规模经济原则实现卫生系统的效率:加强协调,减少分散,从而降低开发和实施数字服务的成本,提供和捆绑专门技术和管理专长以及财政资源,最终减少等待时间,增加年轻人的自我保健。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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