Local Health Trust, Ravenna, Italy.
Health Policy. 2013 Feb;109(2):150-7. doi: 10.1016/j.healthpol.2012.11.003. Epub 2012 Nov 30.
Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance.
医院网络是一种新兴的组织形式，旨在应对公共卫生系统的新挑战。尽管众所周知，网络模型在资源合理化方面带来了好处，但关于利益相关者对医院网络绩效的看法的文献证据很少。我们使用组织有效性的竞争价值观框架及其随后由 Minvielle 等人的改编，于 2009 年在意大利肿瘤护理网络的五家医院进行了一项调查，以检查和比较内部利益相关者（医生、护士和行政人员）对医院网络绩效的看法。共完成了 329 份问卷调查利益相关者的观点，回应率为 65.8%。使用问卷的 66 项的探索性因素分析，我们确定了 4 个因素，即关系的中心性、护理质量、吸引力/声誉和员工赋权以及工人权利的保护。在分析中保留了 42 项。因子得分很高（10 项量表上的平均得分>8），除了吸引力/声誉（平均得分 6.79），这表明利益相关者更重视关系和医疗保健方面。对利益相关者的因子得分进行比较并未发现显著差异，这表明对医院网络绩效的看法大致相同。
