Christensen Jannie Kristine Bang
Center of Organization, Management and Administration, Department of Sociology and Social Work, Aalborg University, Kroghstraede 7, 9220 Aalborg, Denmark.
Int J Integr Care. 2016 Nov 24;16(4):14. doi: 10.5334/ijic.2462.
Previous studies have suggested that telecare can improve interorganisational collaboration within fragmented health care systems, yet this outcome has not been examined in a large-scale setting. This study explores the effects of a large-scale interorganisational telecare programme in Denmark based on home-monitoring on collaboration in a telecare network between municipalities, hospitals, and general practitioners.
Semi-structured interviews and observations of collaborating health professionals from the municipalities, hospitals, and general practitioners were undertaken and then repeated a year later. Collaboration was analysed both at the interorganisational network level and within each part of the network, including its interrelations.
Collaboration between municipalities and general practitioners was initially intensified as a result of implementing telecare, though this changed over time as the first start-up obstacles were overcome and the patients became more active in their treatment. Conversely, collaboration between and was unaffected by telecare.
Changes in collaboration among municipal nurses, general practitioners, and hospital staff were related to dependency structures and municipalities' newly gained central role in a telecare network. While the telecare network was initially characterised by asymmetrical dependency structures, these were partially equalised over time because of the municipalities' new position in the network.
先前的研究表明，远程护理可以改善碎片化医疗保健系统中的组织间协作，但这一结果尚未在大规模环境中得到检验。本研究探讨了丹麦一项基于家庭监测的大规模组织间远程护理计划对市政当局、医院和全科医生之间远程护理网络协作的影响。
对来自市政当局、医院和全科医生的合作医疗专业人员进行了半结构化访谈和观察，一年后重复进行。在组织间网络层面以及网络的每个部分内部，包括其相互关系，对协作进行了分析。
由于实施远程护理，市政当局和全科医生之间的协作最初得到加强，但随着最初的启动障碍被克服以及患者在治疗中变得更加积极，这种情况随时间发生了变化。相反，[此处原文缺失两个主体，无法准确翻译]之间的协作不受远程护理的影响。
市政护士、全科医生和医院工作人员之间协作的变化与依赖结构以及市政当局在远程护理网络中 newly gained central role（此处表述有误，可能是newly gained centrality，可译为“新获得的核心地位”）有关。虽然远程护理网络最初的特点是不对称的依赖结构，但由于市政当局在网络中的新地位，这些结构随着时间的推移部分实现了均衡。
