Local networks of community and healthcare organisations: a mixed methods study

Abstract

BackgroundLocal collaboration of community organisations and healthcare organisations is seen as relevant for the efficiency and efficacy of health and social care because of their potential role in providing social involvement which may reduce the need for the utilisation of formal services. Care organisations connect to each other in different ways, thus comprising an organisational network. This study aimed to describe and explore organisational networks with respect to their activities for people with diabetes mellitus type 2 and potential mechanisms of effective collaboration. Collaboration could include, for example, referring to each other and organising activities together. Potential mechanisms are navigation, negotiation and contagion.MethodsA mixed methods study was conducted in an urban and a rural area in the Netherlands. The participating organisations were mentioned by a sample of diabetes patients in these regions and by organisations’ representatives in a snowballing procedure. Next a quantitative survey and a semi-structured interview were conducted, including 35 representatives of these local organisations. The social network analysis methods was used to map and characterise the organisational networks based on results from the survey. A thematic analysis of interviews was undertaken to identify how three mechanisms (navigation, negotiation and contagion) were used in the collaboration.ResultsBoth interviews and network structures showed evidence of navigation-related mechanisms. Organisations referred patients with diabetes to services within their organisation or to relevant services provided by other organisations. Hardly any negotiation or contagion-related mechanisms were identified. If negotiation between organisations was found, it seemed externally enforced. The density, centrality, and reciprocity in the networks seemed low to facilitate contagion of practices. Some organisations reported actions that could have impacted on contagion. Representatives emphasized the need of network collaboration with local or regional community and healthcare organisations.ConclusionThe study suggests that navigation to resources is a relevant theme in organisational networks, which could be targeted by interventions. More research is needed to explore the relevance of other network-related mechanisms.

General practice and patients’ views of the social networks of patients with multimorbidity

“…Other studies show there is potential to work in collaboration with organisations to better support patients with complex multimorbidity if barriers such as sharing information are overcome. [46][47][48] However, to use social network information, it needs to be readily recorded and retrieved, and in this study, social network supporters were infrequently recorded in the EHR and typically only recalled from memory. If recorded, it could have been in several different fields and not readily searchable or retrievable.…”

“…General practices could consider which groups of patients with multimorbidity would benefit most from routine collection of social network information (as pragmatically, it probably could not be collected for all patients) and also where in the EHR it could be stored. We suggest that social network information be recorded for patients with high numbers of long-term conditions, complex biosocioeconomic and environmental influences, 47 polypharmacy, patients who are isolated, with increasing morbidity or frailty, or who have mental health problems or dementia in the multimorbidity profile. New enrolees with multimorbidity, patients with frequent emergency department attendances or repeated, frequent hospital admissions, or entering the end-of-life phase could also be considered.…”

Versorgungsbedarfe zu Long-COVID aus Sicht von Betroffenen und Hausärzt*innen – eine Mixed-Methods-Studie aus Baden-Württemberg

“…Zusammenfassend bietet sich zur flächeneckenden medizinischen Versorgung von Long-COVID die Entwicklung eines Stufenkonzepts unter Einbezug der hausärztlichen Filterfunktion, Wissenstransfer aus dem universitären Bereich, Nutzung des ambulanten Versorgungsnetzes und weiterer Erhebungen zu diagnostischen Pfaden an [32] . Regionale Netzwerke können zur Navigation zu Ressourcen beitragen [33] und erscheinen für die Etablierung und Umsetzung solcher Strukturen geeignet.…”

Understanding the Development, Evaluation, and Sustainability of Community Health Networks Using Social Network Analysis: A Scoping Review

“…The numbers of organizations in the networks studied ranged from 10 to 868, with analysis occurring at local, regional, and national levels. The majority (48) focused upon specific issues, the most common being mental health (13), followed by violence/injury/abuse (7), reproduction (7), cancer (7), and human immunodeficiency virus (6). Twenty-three were generally focused upon health promotion and disease prevention, and 15 of the networks addressed social determinants of health (SDoH)/disparities.…”