Leadership in Integrated Care

Amelung, Volker Eric; Chase, Daniela; Reichert, Anika

doi:10.1007/978-3-319-56103-5_14

Cited by 10 publications

(16 citation statements)

References 10 publications

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“…To study the topic, researchers use various theoretical lenses. The most important theories are network theory (15), integrated care theory (11), social network theory (7), organisation theory (6) and leadership theory (4), whereby some papers combine two or more lenses. In terms of methods, most studies are qualitative (41).…”

Section: Resultsmentioning

confidence: 99%

“…Reviewing these findings, this section highlights gaps in the literature demanding attention in the future (see Table 2 for a summary). Addressing these gaps may help improve our currently limited understanding of leadership in integrated care networks [15].…”

Section: Discussion and Suggestions For Future Researchmentioning

confidence: 99%

“…Around the globe, policy makers and service providers view collaboration in inter-organisational networks as a promising approach for improving health systems [1,2,4]. Against this background, this article set out to review the current state of knowledge about leadership in integrated care networks, a previously neglected topic in the literature [15]. Studies over the past decades have provided important information on the structures and processes making things happen in integrated care networks, with a particular focus on leadership and outcomes at the network level of analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Enabled and constrained by leadership media, leadership activities are often imbued with tensions in the sense of persistent contradictions between opposite elements so that actors' outcomes are not always as intended [23,[27][28][29]. In contrast to other leadership theories, this definition is less interested in the difference between leadership and management [15,30]. It also reaches beyond leader-oriented theories emphasising individual actors' traits, styles, behaviours or transformational skills [24].…”

Section: Theoretical Backgroundmentioning

confidence: 99%

“…Third, the leadership challenge is exacerbated by the way health and social care services are provided. In these sectors, service provision involves the coordination of activities among multiple, highly specialised expert organisations operating at different levels of the system [15].…”

Section: Introductionmentioning

confidence: 99%

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Leadership in Integrated Care Networks: A Literature Review and Opportunities for Future Research

Mitterlechner

2020

Int J Integr Care

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In many countries, elderly patients with chronic conditions require a web of services delivered by several providers collaborating in inter-organisational networks. In view of their global importance, it is surprising how little we know how these networks are led. Like traditional organisations, networks require leadership to function effectively. This paper reviews central characteristics of leadership in integrated care networks and proposes opportunities for future research. Theory and methods: Analysing 73 studies published in leading academic journals, this paper consolidates research on leadership media, practices, activities and outcomes, covering the network, policy and organisation levels of analysis. Results: Findings indicate that the field has focused on leadership media and outcomes at the network level. They also suggest that leadership in integrated care networks faces multiple tensions. Future research could usefully provide a fuller picture by examining leadership practices, activities and outcomes at the policy and organisation level, integrating advances in the wider leadership literature. Discussion and conclusion: These findings contribute to the debate on leadership in integrated care networks. They also inform practice, drawing attention to persistent tensions as a core leadership challenge and offering latest scholarly evidence practitioners can use to reflect on and advance their own leadership practice.

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Section: Resultsmentioning

confidence: 99%

Section: Discussion and Suggestions For Future Researchmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Theoretical Backgroundmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Leadership in Integrated Care Networks: A Literature Review and Opportunities for Future Research

Mitterlechner

2020

Int J Integr Care

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A path dependence analysis of hospital dominance in China (1949–2018): lessons for primary care strengthening

Gorsky

Mills

2019

Health Policy and Planning

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Although China’s community health system helped inspire the 1978 Alma Ata Declaration on Health for All, it currently faces the challenge of strengthening primary care in response to hospital sector dominance. As the world reaffirms its commitment towards primary health services, China’s recent history provides a salient case study of the issues at stake in optimizing the balance of care. In this study, we have used path dependence analysis to explain China’s coevolution of hospital and primary care facilities between 1949 and 2018. We have identified two cycles of path-dependent development (1949–78 and 1978–2018) involving four sets of institutions related to medical professionalization, financing, organization and governance of health facilities. Both cycles started with a critical juncture amid a radically changing societal context, when institutions favouring hospitals were initiated or renewed, leading to a process of self-reinforcement empowering the hospitals. Later in each cycle, events occurred that modified this hospital dominance. However, pro-primary care policies during these conjunctures encountered resilience from the existing institutional environment. The result was continued consolidation of hospital dominance over the long term. These recurrent constraints suggest that primary care strengthening is unlikely to be successful without a comprehensive set of policy reforms driven by a primary care coalition with strong professional, bureaucratic and community stakes, co-ordinated and sustained over a prolonged period. Our findings imply that it is important to understand the history of health systems in China, where the challenges of health systems strengthening go beyond limited resources and include different developmental paths as compared with Western countries.

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Person‐centred integrated care for people living with Parkinson's, Huntington's and Multiple Sclerosis: A systematic review

Bartolomeu Pires,

Kunkel,

Kipps

et al. 2023

Health Expectations

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IntroductionPeople living with long‐term neurological conditions (LTNCs) have complex needs that demand intensive care coordination between sectors. This review aimed to establish if integrated care improves outcomes for people, and what characterises successful interventions.MethodsA systematic review of the literature was undertaken evaluating multisectoral integrated care interventions in people living with Parkinson's disease (PD), Multiple Sclerosis (MS) and Huntington's disease (HD). Strength of evidence was rated for the different outcomes.ResultsA total of 15 articles were included, reporting on 2095 patients and caregivers, finding that integrated care can improve people's access to resources and reduce patients' depression. UK studies indicated improvements in patients' quality of life, although the international literature was inconclusive. Few programmes considered caregivers' outcomes, reporting no difference or even worsening in depression, burden and quality of life. Overall, the evidence showed a mismatch between people's needs and outcomes measured, with significant outcomes (e.g., self‐management, continuity of care, care experience) lacking. Successful programmes were characterised by expert knowledge, multisectoral care coordination, care continuity and a person‐centred approach.ConclusionsThe impact of integrated care programmes on people living with LTNCs is limited and inconclusive. For a more person‐centred approach, future studies need to assess integrated care from a service‐user perspective.Patient and Public ContributionThirty people living with LTNCs were involved in this review, through defining research questions, validating the importance of the project, and increasing the researchers' understanding on what matters to service users. A patient and public involvement subgroup of representatives with lived experience on PD, MS and HD identified the need for more person‐centred integrated care, with specific concerns over care fragmentation, care duplication and care continuity. This was key to data analysis and formulating the characteristics of successful and unsuccessful integrated care programmes from the perspective of service users. The discrepancy between service users' needs and the outcomes assessed in the literature point to user‐driven research as the solution to address what matters to patients and caregivers.

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Leadership in Integrated Care

Cited by 10 publications

References 10 publications

Leadership in Integrated Care Networks: A Literature Review and Opportunities for Future Research

Leadership in Integrated Care Networks: A Literature Review and Opportunities for Future Research

A path dependence analysis of hospital dominance in China (1949–2018): lessons for primary care strengthening

Person‐centred integrated care for people living with Parkinson's, Huntington's and Multiple Sclerosis: A systematic review

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