PUB - Publikationen an der Universität Bielefeld

Between October 1995 and December 1998 the pilot project 'Local Coordination of Health and Social Care' was conducted in 28 communities of the state of North Rhine-Westphalia. The project has been evaluated by two university research teams. The aim of the project was basically to establish new structures of health planning and coordination at the community level, in order to improve health reporting and health care as well as health promotion. To realize this aim round tables, working groups and project-offices were implemented in the communities. The evaluation was focused on the following question: What were the conditions (structures) and processes that influenced the project outcomes? Qualitative and quantitative methods were applied (interviews, standardised self-administered questionnaires, analyses of documents) to this end. Evaluation of structures showed that most communities succeeded in integrating relevant health policy actors into the newly created round tables and working groups. Working climate and achievements were evaluated favourably by most of the involved actors. All communities succeeded in developing and enacting recommendations for programmes, and about 40% of these programmes were implemented during the project. The probability of programme implementation was particularly high if the programme was based on reliable local data and if execution was effected only on the community level. The possibly beneficial effects on health care and welfare produced by the new programmes could not be assessed within the short project period. The paper concludes with a brief discussion of practical consequences for future health policy at community level.