Research project
Health Governance
Growing health inequalities, rising healthcare costs, an ageing population, and shortages of healthcare staff are just some of the challenges facing healthcare, both in the Netherlands and beyond. These issues transcend the boundaries of the medical sector and touch on broader themes such as social inequality, participation, and well-being. As a result, solutions require interventions at various levels (multi-level governance) and across different domains (multi-sectoral approaches), combining knowledge from medicine with insights from the behavioural sciences, data science, and governance.
- Contact
- Sander Sandkuyl
With this vision in mind, the Institute of Public Administration and Leiden University Medical Centre (LUMC) have embarked on an intensive collaboration centred around the theme of Population Health Governance. This research programme places a strong emphasis on interdisciplinary teamwork, bringing together scientists and clinicians with expertise in leadership, governance, and management within healthcare and the social domain.
On this page, you can learn more about our mission, meet the team, and discover the research lines we are developing in response to current societal challenges.
About the programme
Central to this research programme is the collaboration within an interdisciplinary team of scientists and clinicians, connecting expertise in leadership, governance, and management across healthcare and the social domain.
Research at the intersection of healthcare and governance received a significant boost in 2020 with the launch of the Population Health incentive programme. This university-wide initiative aims to promote health through innovative projects in public management and healthcare, addressing pressing societal issues. In addition to the partnership with LUMC, the programme also collaborates with other disciplines, such as Professor Marieke Adriaanse’s chair in ‘Behavioural Interventions in Population Health Management’ (FSW/LUMC) and Professor Marco Spruit’s chair in ‘Advanced Data Sciences in Population Health’ (FNWI/LUMC).
Research: general
The connection between healthcare, the social domain, and governance is explored through three research themes. Within these themes, a multi-level approach is applied. This means we address issues at the level of the healthcare system, at the level of organisations and networks of organisations, and at the level of professionals within organisations. In addition, we work on cross-domain solutions through a multi-sectoral approach, enabling mutual learning and strengthening across sectors.
The three research themes are defined as follows:
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Defining concepts of health systems
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Bridging social and medical policy-approaches
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Leading adaptive healthcare
The use of concepts is one of several ways in which the healthcare system can be steered. Concepts such as ‘Care in the Right Place’, ‘Value-based Healthcare’, ‘Meaningful Care’, and ‘Appropriate Care’ are based on particular approaches to thinking about and organising care, and have a significant impact on organisations and their staff. This research line examines precisely what these concepts influence within healthcare, how they develop, and what they mean for the organisation of care.
Recent publications
Kraaijeveld, B; Wieringa, S; Engebretsen, E; Bussemaker, J. (2025). How concepts guide policy: an ethnographic study of the meaning making of ‘appropriate care’ in Dutch healthcare. Social Science & Medicine, volume 379, 118152
Goijaerts, J. (2022). Ambiguous policy paradigms in the Dutch welfare state: A gender-blind mix of social investment and conservative care. Social Politics: International Studies in Gender, State & Society, 29(4), 1403-1424.
Recent publications
Social and health issues are deeply intertwined. People with debts often also face health problems and can become entangled in fragmented care and support structures. This research line focuses on strengthening collaboration between the social and medical domains and governance—both in policy and in practice. Central themes include the preconditions for effective cooperation between professionals and public managers at various levels, how tailored approaches are managed in practice, and how sustainable collaboration can be achieved and safeguarded.
Schmidt, E., Bernard B., van der Pas S., (2025) Breaking the rules, but for whom? How client characteristics affect frontline professionals’ prosocial rule-breaking behavior, Journal of Public Administration Research and Theory
Schubad M.J., Bernards B.J.T.H., Pas S. van der & Groeneveld S.M. (2024), Factsheet sturingsreis: een onderzoek naar de rol van publieke managers op verschillende hiërarchische niveaus in het sturen op maatwerk. Leiden: Universiteit Leiden.
Schubad M.J., Bernards B.J.T.H., Pas S. van der & Groeneveld S.M. (2024), Factsheet dagboekstudie: een onderzoek naar alledaagse teamfactoren die het leveren van maatwerk stimuleren. Leiden: Universiteit Leiden.
Schubad M.J. (19 november 2024), De sturingsreis. The Hague : Platform O (Institute of Public Administration). [webartikel].
van Heteren, F., Raaphorst, N., Groeneveld, S. M., & Bussemaker, M. (2024). Interprofessional collaboration in fluid teams: an ethnographic study in a Dutch healthcare context. Journal of Interprofessional Care, 1-9.
van Heteren, F., Raaphorst, N. J., & Bussemaker, J. M. (2024). Health promotion roles shaped by professional identity: an ethnographic study in the Netherlands. Health Promotion International, 39(1), daad195.
Visser, E.L., Bernards. B.J.H.T. & Schmidt, E. (2024). Maatwerk onder
maatschappelijke druk. Inleiding tot themanummer. Bestuurskunde 33 (4), 1-12.
Bernards B.J.T.H., Pas S. van der, Schmidt J.E.T. & Bosch E.J. (2023), Factsheet: onderzoek Leeratelier Maatwerk & Regie. Leiden: Leiden University.
Schmidt, E., Schalk, J., Ridder, M., van der Pas, S., Groeneveld, S. & Bussemaker, M. (2022). Collaboration to combat COVID-19: policy responses and best practices in local integrated care settings. Journal of Health Organization and Management. https://doi.org/10.1108/JHOM-03-2021-0102
Toshkov, D., & Mazepus, H. (2022). Does the Election Winner-Loser Gap Extend to Subjective Health and Well-Being? Political Studies Review, 0(0). https://doi.org/10.117/14789299221124735
Bernards B. & Schmidt E. (2021), Regels breken in het belang van de burger. Van rebelse leidinggevende naar rebelse professional?, B en M: tijdschrift voor beleid, politiek en maatschappij 48(2): 156-173.
In recent years, the importance of being able to respond flexibly to changing circumstances and unpredictable outcomes has become increasingly clear. The shift towards joint decision-making, integrated working, and a focus on the human dimension requires greater adaptability in both the short and long term. At the level of the system, the organisation, and the professional, this research line explores how to remain attentive and responsive to what is needed.
Recent publications
Goijaerts, J., van der Zwan, N., & Bussemaker, J. (2025). How middle managers perceive and articulate the discrepancy between socio-health service delivery goals and practice. Policy & Politics, 1-20.
Visser, E. L. (2024). Enabling street-level work: minimal structures for customized social services. Public Management Review, 1-18.
Visser, E.L. & van Gelder, J. (2024). Spanningen in street-level leiderschap: Hoe managers sturen op maatwerk en verantwoording. Bestuurskunde 33 (4), 66- 78.