Schepman Sanneke, Valentijn Pim, Bruijnzeels Marc, Maaijen Marlies, de Bakker Dinny, Batenburg Ronald, de Bont Antoinette
NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, the Netherlands.
Department of Health Services Research, School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200MD, Maastricht, the Netherlands.
BMC Health Serv Res. 2018 Jun 7;18(1):427. doi: 10.1186/s12913-018-3169-8.
The need for organisational development in primary care has increased as it is accepted as a means of curbing rising costs and responding to demographic transitions. It is only within such inter-organisational networks that small-scale practices can offer treatment to complex patients and continuity of care. The aim of this paper is to explore, through the experience of professionals and patients, whether, and how, project management and network governance can improve the outcomes of projects which promote inter-organisational collaboration in primary care.
This paper describes a study of projects aimed at improving inter-organisational collaboration in Dutch primary care. The projects' success in project management and network governance was monitored by interviewing project leaders and board members on the one hand, and improvement in the collaboration by surveying professionals and patients on the other. Both qualitative and quantitative methods were applied to assess the projects. These were analysed, finally, using multi-level models in order to account for the variation in the projects, professionals and patients.
Successful network governance was associated positively with the professionals' satisfaction with the collaboration; but not with improvements in the quality of care as experienced by patients. Neither patients nor professionals perceived successful project management as associated with the outcomes of the collaboration projects.
This study shows that network governance in particular makes a difference to the outcomes of inter-organisational collaboration in primary care. However, project management is not a predictor for successful inter-organisational collaboration in primary care.
随着初级保健被视为控制成本上升和应对人口结构转变的一种方式，对其组织发展的需求也在增加。只有在这样的组织间网络中，小规模的医疗机构才能为复杂患者提供治疗并实现连续护理。本文旨在通过专业人员和患者的经验，探讨项目管理和网络治理是否以及如何能够改善促进初级保健组织间合作的项目成果。
本文描述了一项针对旨在改善荷兰初级保健组织间合作的项目的研究。一方面，通过采访项目负责人和董事会成员来监测项目在项目管理和网络治理方面的成功情况；另一方面，通过对专业人员和患者进行调查来评估合作的改善情况。采用定性和定量方法对项目进行评估。最后，使用多层次模型进行分析，以考虑项目、专业人员和患者之间的差异。
成功的网络治理与专业人员对合作的满意度呈正相关；但与患者所体验到的护理质量改善无关。患者和专业人员均未将成功的项目管理视为与合作项目的成果相关。
本研究表明，特别是网络治理对初级保健组织间合作的成果有影响。然而，项目管理并非初级保健组织间成功合作的预测指标。
