%0 Journal Article 
%A Selgas, Rafael
%A Rodríguez, Laura
%A Julián, Juan Carlos
%A Remón Rodríguez, César
%A Prieto Velasco, Mario
%A Pérez Contreras, Javier
%A Pérez Fontán, Miguel
%T How a Bottom-Up Multi-Stakeholder Initiative Helped Transform the Renal Replacement Therapy Landscape in Spain
%D 2017
%@ 1179-1896

%U http://hdl.handle.net/10498/36653
%X Healthcare reforms aim to change certain parts of the health system to improve quality of care, access, or financial sustainability. Traditionally, healthcare reform is understood as an action undertaken by a government at a national or local level. However, bottom-up changes can also lead to improvements in the health system. This paper describes the efforts of a coordinated multi-stakeholder advocacy group in Spain to promote a more cost-effective and patient-centred treatment for people receiving renal replacement therapy and assesses the outcomes of their advocacy for health system financing and patient satisfaction. It concludes that bottom-up initiatives do indeed have the power to change health policy and that policy makers should pay attention to their arguments.
%~ Universidad de Cádiz