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城市健康中心的跨部门合作:对支持性组织要素和个体驱动因素的多地点定性研究

Inter-Sectoral Collaboration in Municipal Health Centres: A Multi-Site Qualitative Study of Supporting Organizational Elements and Individual Drivers.

作者信息

Kousgaard Marius Brostrøm, Scheele Christian Elling, Vrangbæk Karsten

机构信息

The Research Unit for General Practice and Section of General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, DK.

Centre for Healthy Aging, Centre for Health Economics, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, DK.

出版信息

Int J Integr Care. 2019 Jun 21;19(2):9. doi: 10.5334/ijic.4196.

Abstract

INTRODUCTION

Community health centres accommodating different professional groups are expected to improve inter-sectoral collaboration between primary care providers. This study aimed to identify what has been done to support inter-sectoral collaboration between municipal professionals and general practitioners in health centres, and to explore the interactions that emerge between these professionals at the operational level.

METHODS

The study was a multi-site qualitative study carried out in four municipal health centres in a Danish region. The study was based on documents and qualitative interviews with general practitioners, and municipal professionals and administrators in each of the health centres. A content analysis was conducted.

RESULTS

The study found that little attention had been given to the organizational prerequisites for enhanced inter-sectoral collaboration in the health centres. Even though some health centres had employed coordinators, these did not play a significant role as facilitators of collaboration partly due to a lack of political and managerial attention. At the operational level, inter-sectoral collaboration was limited to ad hoc interactions between professionals. Although these interactions could be useful, they did not evolve into more systematic forms of collaboration.

CONCLUSION

The gap between policy visions and actual implementation efforts found in this study suggests that a more active and focused engagement from the political-administrative level is needed if the visions of increased inter-sectoral collaboration in health centres are to be realised.

摘要

引言

容纳不同专业群体的社区健康中心有望改善初级保健提供者之间的跨部门协作。本研究旨在确定为支持健康中心的市政专业人员与全科医生之间的跨部门协作所做的工作,并探讨这些专业人员在运营层面出现的互动情况。

方法

该研究是一项在丹麦一个地区的四个市政健康中心开展的多地点定性研究。该研究基于文件以及对每个健康中心的全科医生、市政专业人员和管理人员的定性访谈。进行了内容分析。

结果

研究发现,健康中心对加强跨部门协作的组织前提条件关注甚少。尽管一些健康中心聘用了协调员,但这些协调员并未作为协作促进者发挥重要作用,部分原因是缺乏政治和管理层面的关注。在运营层面,跨部门协作仅限于专业人员之间的临时互动。尽管这些互动可能有用,但并未发展为更系统的协作形式。

结论

本研究中发现的政策愿景与实际实施努力之间的差距表明,如果要实现健康中心加强跨部门协作的愿景,政治行政层面需要更积极且有重点的参与。

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