Health systems have long been considered key determinants of well-being within modern societies, a valuable resource which have faced a series of reform initiatives throughout the past decades. These reforms have been used to manage the cost of development, measure the tenability of health systems in globalizing economies and promote the increasing importance of health problems related to lifestyle and living conditions, yet they have failed to provide a true resolution to the persistent economical and logistical problems facing modern-day health systems.

This rich, interdisciplinary work explores the hypothesis that many of these problems cannot be adequately addressed without structural changes to our health systems, and examines the embedded features of our health systems that underlie contemporary challenges as well as how, and under what conditions, our health systems can be made more sustainable. Combining and building upon theoretical approaches from transition and innovation studies for analysing health system deficits, Toward Sustainable Transitions in Healthcare Systems raises fundamental questions about how new research, new needs and exogenous trends are transforming current health innovation systems.

Providing an original and substantial analysis of the complex structural features of the health innovation system, this book will be of interest to students and practitioners of the politics of health, social epidemiology, medical sociology and those with an interest in transition theory.


chapter 1|20 pages


ByJohn Grin, Jacqueline E.W. Broerse

part 1|64 pages

Historical studies on health system changes

chapter 2|23 pages

Contested health system, 1970 to the present

ByEric Berkers

chapter 3|39 pages

Key features of modern health systems

Nature and historical evolution
ByRoel van Raak, Fjalar J. de Haan

part II|174 pages

Innovative practices at the niche level

chapter 4|23 pages

Unraveling persistent problems through analyzing innovative practices in healthcare

ByTjerk Jan Schuitmaker, Erica ter Haar-van Twillert

chapter 5|22 pages

System innovation

Workplace health development
ByLenneke Vaandrager, Ingrid Bakker, Maria Koelen, Paul Baart, Tamara Raaijmakers

chapter 6|21 pages

Toward a sustainable welfare and health system in Spain

Experiences with the case management program
ByFrancisco Ródenas, Jorge Garcés

chapter 7|30 pages

The making of a Transition Program in the Dutch care sector 1

BySuzanne Van den Bosch, Jord Neuteboom

chapter 8|25 pages

Trying to transform structure, culture and practice

Comparing two innovation projects of the Transition Program in Long-term Care
ByErica ter Haar-van Twillert, Suzanne Van den Bosch

chapter 9|27 pages

Contextualizing evidence in Canadian healthcare

The EXTRA program
ByDavid Clements, Dirk Essink

chapter 10|24 pages

Toward a needs-oriented health research system

Involving patients in health research
ByJanneke E. Elberse, Willem I. de Boer, Jacqueline E.W. Broerse

part III|28 pages


chapter 11|26 pages

The future of health systems

Beyond the persistence of contemporary challenges
ByJacqueline E.W. Broerse, John Grin