Auschra Carolin
Freie Universität Berlin, Department of Management, Boltzmannstr. 20, 14195 Berlin, DE.
Int J Integr Care. 2018 Jan 16;18(1):5. doi: 10.5334/ijic.3068.
In recent years, inter-organisational collaboration between healthcare organisations has become of increasingly vital importance in order to improve the integration of health service delivery. However, different barriers reported in academic literature seem to hinder the formation and development of such collaboration.
This systematic literature review of forty studies summarises and categorises the barriers to integrated care in inter-organisational settings as reported in previous studies. It analyses how these barriers operate.
Within these studies, twenty types of barriers have been identified and then categorised in six groups (barriers related to administration and regulation, barriers related to funding, barriers related to the inter-organisational domain, barriers related to the organisational domain, barriers related to service delivery, and barriers related to clinical practices). Not all of these barriers emerge passively, some are set up intentionally. They are not only context-specific, but are also often related and influence each other.
The compilation of these results allows for a better understanding of the characteristics and reasons for the occurrence of barriers that impede collaboration aiming for the integration of care, not only for researchers but also for practitioners. It can help to explain and counteract the slow progress and limited efficiency and effectiveness of some of the inter-organisational collaboration in healthcare settings.
近年来，医疗保健机构之间的组织间合作对于改善卫生服务提供的整合变得越来越至关重要。然而，学术文献中报道的不同障碍似乎阻碍了这种合作的形成和发展。
这项对40项研究的系统文献综述总结并分类了先前研究中报道的组织间环境下综合护理的障碍。它分析了这些障碍是如何起作用的。
在这些研究中，已确定了20种类型的障碍，然后将其分为六组（与行政和监管相关的障碍、与资金相关的障碍、与组织间领域相关的障碍、与组织领域相关的障碍、与服务提供相关的障碍以及与临床实践相关的障碍）。并非所有这些障碍都是被动出现的，有些是故意设置的。它们不仅因具体情况而异，而且往往相互关联并相互影响。
这些结果的汇总不仅有助于研究人员，也有助于从业者更好地理解阻碍旨在实现护理整合的合作的障碍的特征和出现原因。它可以帮助解释并应对医疗保健环境中一些组织间合作进展缓慢以及效率和效果有限的问题。
