Adv Health Care Manag. 2024 Feb 7;22. doi: 10.1108/S1474-823120240000022009.
At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.
在 21 世纪初，包括公众（消费者）、私营和非营利医疗机构、政府（公共卫生）和其他行业部门在内的多个多元化的社会实体开始认识到当前碎片化的医疗体系范式的局限性。主要利益相关者，包括雇主、保险公司和医疗专业组织，也对不可接受的健康结果和不断上升的成本表示不满。重大挑战和棘手问题威胁着卫生部门的生存能力。美国医疗系统通过医疗保健提供框架的创新和进步做出了回应，鼓励从部门内和部门间的安排向多部门、持久的关系转变，强调以患者为中心，并对可持续性和问责制做出长期承诺。这条通往人口健康方法的途径也产生了对变革性商业模式的需求。强调跨部门一致性、非传统伙伴关系、可持续使命和能够产生投资回报的问责制的健康共同生产框架已经成为应对非卫生部门公司带来的破坏性威胁和挑战的独特策略。本章介绍了健康共同生产框架、目标和标准、跨越边界的网络联盟模型示例以及运营（整合者、召集者、聚合者）策略。对重要的组织科学理论的比较，包括制度理论、网络/网络分析理论和资源依赖理论，为未来的研究方向提供了建议，这些研究方向对于验证健康共同生产框架作为范式变革的前奏的效用是必要的。
