Faculty of Health, Welfare and Organisation, Østfold University College, Halden, Norway.
Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway.
J Health Organ Manag. 2022 Mar 16;ahead-of-print(ahead-of-print):95-111. doi: 10.1108/JHOM-10-2020-0401.
New Public Management (NPM) has increased fragmentation in municipal health and social care organizations. In response, post-NPM reforms aim to enhance integration through service integration. Integration of municipal services is important for people with complex health and social challenges, such as concurrent substance abuse and mental health problems. This article explores the conditions for service integration in municipal health and social services by studying how public management values influence organizational and financial structures and professional practices.
DESIGN/METHODOLOGY/APPROACH: This is a case study with three Norwegian municipalities as case organizations. The study draws on observations of interprofessional and interagency meetings and in-depth interviews with professionals and managers. The empirical field is municipal services for people with concurrent substance abuse and mental health challenges. The data were analyzed both inductively and deductively.
The study reveals that opportunities to assess, allocate and deliver integrated services were limited due to organizational and financial structures as the most important aim was to meet the financial goals. The authors also find that economic and frugal values in NPM doctrines impede service integration. Municipalities with integrative values in organizational and financial structures and in professional approaches have greater opportunities to succeed in integrating services.
ORIGINALITY/VALUE: Applying a public management value perspective, this study finds that the values on which organizational and financial structures and professional practices are based are decisive in enabling and constraining service integration.
新公共管理（NPM）增加了市立卫生和社会保健组织的碎片化。作为回应，后 NPM 改革旨在通过服务整合来增强整合。市立服务的整合对于同时存在药物滥用和心理健康问题等复杂健康和社会挑战的人来说非常重要。本文通过研究公共管理价值观如何影响组织和财务结构以及专业实践，探讨了市立卫生和社会服务中服务整合的条件。
设计/方法/途径：这是一项案例研究，以三个挪威市立组织作为案例组织。该研究借鉴了对专业人员和管理人员的跨专业和跨机构会议的观察以及深入访谈。实证领域是同时存在药物滥用和心理健康挑战的人的市立服务。数据进行了归纳和演绎分析。
该研究表明，由于组织和财务结构的限制，评估、分配和提供综合服务的机会有限，因为最重要的目标是实现财务目标。作者还发现，NPM 学说中的经济和节俭价值观阻碍了服务整合。在组织和财务结构以及专业方法中具有整合价值观的市立单位，有更大的机会成功整合服务。
原创性/价值：本研究从公共管理价值观的角度出发，发现组织和财务结构以及专业实践所依据的价值观对于促进和限制服务整合具有决定性作用。
