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网络平台如何助力参与主体实现综合医疗治理?以荷兰一个医院区域为例的研究

How does a Network Platform Work for Participating Actors Towards Integrated Care Governance? A Case Study of a Dutch Hospital Region.

作者信息

van der Woerd Oemar, van Veen-Berkx Elizabeth, van der Scheer Wilma, Bal Roland

机构信息

Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, NL.

Erasmus Centre for Healthcare Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, NL.

出版信息

Int J Integr Care. 2022 Dec 20;22(4):20. doi: 10.5334/ijic.6736. eCollection 2022 Oct-Dec.

Abstract

INTRODUCTION

Network platforms are interesting for integrated care governance as they seek solutions for the problem of competition and tensions between networks. In this paper, we analyse how a network platform functions for the actors involved, and how it is used in their work.

METHODS

We employed a case study in a Dutch urbanised hospital region, and conducted 17 interviews with hospital physicians, directors, and supporting staff who are involved in a network platform called "BeterKeten" (BK).

RESULTS

Actors assign different functions and purposes to BK: facilitating and legitimising professional (learning) communities; adapting to a changing policy context; enlarging professionals' and the networks' circle of influence; and extending governing possibilities. Network platform' dynamics and frictions entail changing professional and managerial practices; embedding a BK network in a partner network; and alignment of (conflicting) network platforms.

DISCUSSION

Network platforms are a promising strategy to govern, facilitate, and nurture network-building actions to enhance integrated care, offering new ways of working to cope with its multi-level nature.

CONCLUSION

BK is a dynamic actor with steering capacities that enables the co-existence of multiple purposes. Further research could pay attention to how network platforms are able to develop modalities of integrated care governance that suit healthcare system's networked character.

摘要

引言

网络平台对于综合医疗治理而言颇具吸引力,因为它们在探寻解决网络间竞争与紧张关系问题的方案。在本文中,我们分析了网络平台如何为相关参与者发挥作用,以及它在他们的工作中是如何被运用的。

方法

我们在荷兰一个城市化的医院区域开展了一项案例研究,并对参与一个名为“BeterKeten”(BK)的网络平台的医院医生、主任及辅助人员进行了17次访谈。

结果

参与者为BK赋予了不同的功能和目的:促进专业(学习)社区并使其合法化;适应不断变化的政策环境;扩大专业人员和网络的影响范围;以及拓展治理可能性。网络平台的动态变化和摩擦带来了专业和管理实践的改变;将BK网络嵌入合作伙伴网络;以及协调(相互冲突的)网络平台。

讨论

网络平台是治理、促进和培育网络建设行动以加强综合医疗的一项有前景的策略,为应对其多层次性质提供了新的工作方式。

结论

BK是一个具有导向能力的动态参与者,能够实现多种目的的共存。进一步的研究可以关注网络平台如何能够发展出适合医疗保健系统网络特性的综合医疗治理模式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41da/9783954/c778daa25ee4/ijic-22-4-6736-g1.jpg

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