Decision-Making Dilemmas within Integrated Care Service Networks: A Systematic Literature Review

Michgelsen, Jessica; Glimmerveen, Ludo; Pittens, Carina A. C. M.; Minkman, Mirella

doi:10.5334/ijic.6458

Cited by 3 publications

(3 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…IHNs, as micro levels in regionalized health systems, have been promoted in health systems to overcome the fragmentation due to decentralization and promote population health and coordination capacity of regionalized networks (32)(33)(34). The fundamental principles behind regionalized systems of care at the operational level, as proposed by Walton and Mohr (2021), are standard selection, infrastructure design and development, data collection and surveillance, and performance veri cation (10).…”

Section: Discussionmentioning

confidence: 99%

Toward Iran's health system regionalization: a qualitative approach.

Eskandarian,

Raeisi,

Ferdosi

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Regionalized health systems are expected to provide an integrated chain of services for a defined population. However, developing such systems is possible only through alignment across policy, administrative/coordinative, and operational levels. The present study aimed to identify the requirements for such alignment among various levels of Iran's health system. Methods: This qualitative study was conducted with experts in related departments of the Ministry of Health and Medical Education in Iran and selected universities over 5 months in 2023-2024. Fifteen semi-structured interviews were conducted with policymakers and academic experts to collect the study data. The data were grouped into three themes based on thematic content analysis using the MAXQDA software. Results: Three main categories of requirements for developing regionalized health systems, encompassing policy, administrative/ coordinative, and operational levels, and 23 sub-themes, were extracted. Like other hierarchical health systems, the country's health system faces fundamental challenges due to insufficient organizational infrastructure, which hinders its transition into an integrated healthcare management system. Conclusions: Given the legal obligations imposed on the Ministry of Health and Medical Education to establish an integrated regionalized health system and the failure of the relevant initiatives, it is critical to develop the essential infrastructural requirementsacross levels to achieve this goal.

show abstract

Section: Discussionmentioning

confidence: 99%

Toward Iran's health system regionalization: a qualitative approach.

Eskandarian,

Raeisi,

Ferdosi

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…While all actors involved can contribute in their own unique ways, this is not to say that all actors are necessarily "equivalent." That is, (perceived) differences in power and status may exist, which may hinder joint working [33,82,83]. Dos Santos and Giovanella [84], for instance, described how political stakeholders offered health administrators little room to speak up, causing them to have little influence on the decisions about new health policies in Brazil.…”

Section: Discussionmentioning

confidence: 99%

“…The delivery of integrated care services can, at its very basis, be regarded as a joint decision-making process in which multiple actors with different backgrounds, interests, values, perspectives, and expertise try to make joint decisions regarding the delivery of integrated care services [cf. 31,32,33]. Such decision-making processes occur at different levels [4].…”

Section: Integrated Care As a Joint Decision-making Processmentioning

confidence: 99%

From Integrated Care to Integrating Care: A Conceptual Framework of Behavioural Processes Underlying Effective Collaboration in Care

Kee,

Nies,

van Wieringen

et al. 2023

International Journal of Integrated Care

View full text Add to dashboard Cite

Introduction: At all levels, effective collaboration between actors with different backgrounds lies at the heart of integrated care. Much attention has been given to the structural features underlying integrated care, but even under structurally similar circumstances, the effectiveness of collaboration varies largely.Theory and methods: Social and organizational psychological research shows that the extent to which collaboration is effective depends on actors' behaviours. We leverage insights from these two research fields and build a conceptual framework that helps untangle the behavioural processes underlying effective collaboration. Results:We delineate that effective collaboration can be realized when actors (1) speak up about their interests, values, and perspectives (voice behaviour), (2) listen to the information that is shared by others, and (3) thoroughly process this information. We describe these behaviours and explain the motivations and conditions driving these. In doing so, we offer a conceptual framework that can be used to explain what makes actors collaborate effectively and how collaboration can be enhanced. Discussion and conclusion:Fostering effective collaboration takes time and adequate conditions, fitting the particular context. As this context continuously changes, the processes and conditions require continuous attention. Integrated care, therefore, actually requires a carefully designed process of integrating care.

show abstract

Negotiating care in organizational borderlands: a grounded theory of inter-organizational collaboration in coordination of care

Hedqvist,

Lindberg,

Hagerman

et al. 2024

BMC Health Serv Res

View full text Add to dashboard Cite

Background Although coordination of care and integrated care models aim to enhance patient satisfaction and perceived care quality, evidence regarding their practical implementation remains scarce. Understanding the nuances of collaboration across care providers to achieve effective coordination of care is imperative for seamless care integration. The aim of this study was to construct a grounded theory of how inter-organizational collaboration is performed to support coordination of care for patients with complex care needs. Methods A qualitative design with a constructivist grounded theory approach was applied. In total, 86 participants with diverse backgrounds were recruited across multiple care settings, including hospitals, ambulance services, primary care centers, municipal home healthcare and home care services. The grounded theory was developed iteratively, based on a combination of observations and interviews, and using constant comparative analysis. Results Coordination of care, a complex process that occurs across interconnected healthcare organizations, is manifested as “Negotiating care in organizational borderlands.” Care coordination evolves through a spectrum of inter-organizational collaboration, ranging from “Dividing care by disease-specific expertise” to “Establishing paths for collaboration” and ultimately “Co-constructing a comprehensive whole.” These categories highlight the challenges of coordinating care across both professional and organizational boundaries. In the multifaceted healthcare landscape, effective care coordination occurs when healthcare professionals actively bridge the divides, leveraging their collective expertise. Importantly, organizational boundaries may serve a purpose and should not be dissolved to facilitate effective care coordination. Conclusions The key to effective care coordination lies in robust inter-organizational collaboration. Even when patients receive integrated care, healthcare professionals may have fragmented roles. This research emphasizes the importance of clearly defined lines of accountability, reinforcing mutual responsibility and facilitating bridging of professional and organizational boundaries. Healthcare professionals and policymakers can use these insights to effectively utilize inter-organizational collaboration in supporting care coordination for patients with complex care needs.

show abstract

Decision-Making Dilemmas within Integrated Care Service Networks: A Systematic Literature Review

Cited by 3 publications

References 51 publications

Toward Iran's health system regionalization: a qualitative approach.

Toward Iran's health system regionalization: a qualitative approach.

From Integrated Care to Integrating Care: A Conceptual Framework of Behavioural Processes Underlying Effective Collaboration in Care

Negotiating care in organizational borderlands: a grounded theory of inter-organizational collaboration in coordination of care

Contact Info

Product

Resources

About