عوامل داخلی ساختاری و عملیاتی تأثیرگذار بر طراحی مدل حکمرانی شبکه در سیستم‌های مراقبت از سلامت: مرور نظام‌مند ادبیات
محورهای موضوعی : مدیریت دانشرضا عالیخانی 1 , علیرضا علی احمدی 2 , محمدرصا رسولي 3
1 - دانشگاه علم و صنعت
2 - دانشگاه علم و صنعت ایران
3 - دانشگاه علم و صنعت ایران
کلید واژه: سیستم‌های مراقبت سلامت عوامل تأثیرگذار ساختاری و عملیاتی طراحی مدل حکمرانی شبکه¬, ای مرور نظام¬, مند ادبیات,
چکیده مقاله :
با توجه بازار رقابتی امروزی در نظام سلامت، همکاری شبکه‌ای تبدیل به یک استراتژی اساسی جهت بقای سازمان‌ها شده است. توفیق راهبردی یک شبکه همکاری مستلزم بهره گیری از مدلی حکمرانی مناسب بین سازمان های ارائه دهنده خدمات در نظام سلامت است. عوامل گوناگونی بر طراحی موفق مدل حکمرانی شبکه ای در نظام سلامت تأثیرگذار هستند که توجه به این عوامل در طراحی موفق مدل حکمرانی شبکه‌ای حیاتی است. هدف از انجام این پژوهش شناسایی عوامل داخلی ساختاری و عملیاتی بوده که بر طراحی مناسب مدل حکمرانی شبکه‌ای در سیستم‌های ارائه خدمات سلامت اثر می‌گذارند. روش پژوهش: جهت شناسایی و استخراج فاکتورهای مورد نظر، از شواهد ذکر شده در ادبیات در استفاده می‌شود. بدین منظور نیازمند روشی هستیم که ادبیات موضوع را به‌طور جامع و سامانمند در نظر گیرد، برای رسیدن به این هدف مرور نظام‌مند ادبیات به منظور شناسایی شواهد معتبر و به‌عنوان روشی فراگیر و سامانمند در نظر گرفته شد. همچنین جهت ترکیب شواهد استخراج شده از روش گراندد تئوری بهره گرفته شد. یافته‌ها: با جستجوی در پایگاه داده‌ی WEB OF SCIENCE به‌عنوان یک پایگاه جامع و معتبر جهت کشف مطالعات مرتبط، 2350 مقاله حاصل گردید. غربالگری نتایج بر اساس متناسب بودن عناوین مقالات با معیارهای ورودی و خروجی مطالعات به 150 مقاله منجر گردید. نهایتاً با غربالگری 150 مقاله مذکور بر اساس تناسب چکیده و نتیجه‌گیری آن‌ها، به انتخاب 53 مقاله‌ی نهایی انجامید که طی مرور آن‌ها 87 قطعه شواهد از 37 انتشار علمی استخراج گردید و از مطالعات دیگر شواهدی کشف نشد. جهت ایجاد دیدگاه جامع و دسترسی آسان به شواهد استخراج شده در مرحله‌ی ترکیب شواهد با استفاده از متدولوژی گراندد تئوری، 2 گروه از شواهد مجموعا شامل 16 کلاس ایجاد شد. نتیجه‌گیری: طراحی مدل حکمرانی در شبکه در صورتی موفق آمیز بوده که عوامل داخلی ساختاری و عملیاتی در طراحی آن در نظر گرفته شود. در این پژوهش عوامل مرتبط در دو دسته اصلی شامل عوامل مرتبط با مشخصات شبکه نظیر سطح انعطاف پذیری، سطح بلوغ منابع، سطح تمرکز در شبکه و عوامل مرتبط با ویژگی های حکمرانی شبکه مانند ساختار تصمیم گیری، مکانیسم های ارزیابی و مشروعیت در شبکه شناسایی شدند.
Introduction: todays, with regard to competitive market in health system collaboration networked clllaboration has become an essensial strategy for the survival of organizations. Network governance that refers to coordination and collaboration in the network is a fundamental concept that affect collaboration network success. There are various factors that affect designing successful model of network governance that considering this factors is critical for designing successful model of network governance. The aim of doing this research is identifying internal structural and operational factors that affects designing proper model of network governance in health care delivery systems. Methodology: to identify and extract desired factors used of the mentioned evidence in the literature related to research question. For this porpous we need a research methodology that comprehensively and systematically consider the literature. For achieving this aim a systematic literature review will consider as a comprehensive and systematic method for identifying valid evidence and related to the research question. Also, Grounded Theory method was used to synthesis the extracted evidence. Results: by searching in the WEB OF SCIENCE as a comprehensive and credible database for identifying related studies, the 2350 scientific publication resulted. By screening these results basis of title fitness with studies inclusion and exclusion criteria lead to select 150 articles. Finally, through screening described the 150 articles basis of their abstract and conclusion fitness lead to the 53 final articles that during the reviewing them the 78 pieces of evidences extracted from the 37 sources and did not identify any evidence from other studies. For creating extensive view and easy access to extracted evidences in the synthesizing step using granded theory, 2 categories and 16 classes emerged. Conclusion: designing governance model in the network will be successful if only internal structural and operational factors influencing on designing it have been considered. Structural and operational factors in the network include network characteristics and network administration characteristics, are influencing factors that considering these factors on designing proper model of governance lead to fitness of the goernance model with network characteristics that finally lead to collaboration network success.
1. Guo C, Acar M. Understanding collaboration among nonprofit organizations: Combining resource dependency, institutional, and network perspectives. Nonprofit Volunt Sect Q. 2005;34(3):340–61.
2. Retrum JH, Chapman CL, Varda DM. Implications of Network Structure on Public Health Collaboratives. Heal Educ Behav. 2013 Oct;40(1):13S-23S.
3. Mays GP, Scutchfield FD. Improving public health system performance through multiorganizational partnerships. Prev Chronic Dis. 2010;7(6):116–27.
4. Leurs MTW, Mur-Veeman IM, van der Sar R, Schaalma HP, De Vries NK. Diagnosis of sustainable collaboration in health promotion - A case study. BMC Public Health. 2008 Nov;28(8):382–97.
5. Axelsson R, Axelsson SB. Integration and collaboration in public health--a conceptual framework. Int J Health Plann Manage. 2006;21(1):75–88.
6. Supper I, Catala O, Lustman M, Chemla C, Bourgueil Y, Letrilliart L. Interprofessional collaboration in primary health care: a review of facilitators and barriers perceived by involved actors. Vol. 37, Journal of public health (Oxford, England). 2015. p. 716–27.
7. Arya B, Lin Z (John). Understanding collaboration outcomes from an extended resource-based view perspective: The roles of organizational characteristics, partner attributes, and network structures. J Manage. 2007 Oct;33(5):697–723.
8. Van Eyk, H, Baum F. Learning About Interagency Collaboration: Trialing Collaborative Projects Between Hospitals and Community Health Services. Heal Soc Care Community. 2002;10(4),(4):p 262-269.
9. Provan KG, Beagles JE, Leischow SJ. Network formation, governance, and evolution in public health: The North American Quitline Consortium case. Health Care Manage Rev [Internet]. 2011;36(4):315–26.
10. Shortell SM. Increasing value: A research agenda for addressing the managerial and organizational challenges facing health care delivery in the United States. Med Care Res Rev. 2004;61(3 SUPPL.):12–30.
11. Provan KG, Kenis P. Modes of network governance: Structure, management, and effectiveness. J Public Adm Res Theory. 2007 Apr;18(2):229–52.
12. Willem A, Gemmel P. Do governance choices matter in health care networks?: an exploratory configuration study of health care networks. BMC Health Serv Res [Internet]. 2013 Jun;13(1):229–30.
13. Raab J, Mannak RS, Cambré B, Cambre B. Combining structure, governance, and context: A configurational approach to network effectiveness. J Public Adm Res Theory. 2015 Apr;25(2):479–511.
14. Wiktorowicz MME, Fleury M-JM, Adair CE, Lesage A, Goldner E, Peters S. Mental health network governance: comparative analysis across Canadian regions. Int J Integr Care [Internet]. 2010;10(3):128–31.
15. Patru D, Lauche K, Van Kranenburg H, Ziggers GW. Multilateral Boundary Spanners. Med Care Res Rev. 2015;72(6):665–86.
16. Nembhard IM, Tucker AL. Applying Organizational Learning Research to Accountable Care Organizations. Med Care Res Rev. 2016;73(6):673–84.
17. Thelaus J, Lindberg A, Lambertz ST, Bystrom M, Forsman M, Lindmark H, et al. Network Experiences from a Cross-Sector Biosafety Level-3 Laboratory Collaboration: A Swedish Forum for Biopreparedness Diagnostics. Heal Secur [Internet]. 2017;15(4):384–91.
18. Gittell JH, Weiss L. Coordination networks within and across organizations: A multi-level framework. J Manag Stud. 2004 Jan;41(1):127–53.
19. Mascia D, Di Vincenzo F, Cicchetti A. Dynamic analysis of interhospital collaboration and competition: Empirical evidence from an Italian regional health system. Health Policy (New York). 2012 May;105(2–3):273–81.
20. Proenca EJ, Rosko MD, Dismuke CE. Service collaboration and hospital cost performance: direct and moderating effects. Med Care [Internet]. 2005 Dec;43(12):1250–8.
21. Lapao LV, Arcencio RA, Popolin MP, Bandeira Rodrigues LB, Lapão LV, Arcêncio RA, et al. The role of Primary Healthcare in the coordination of Health Care Networks in Rio de Janeiro, Brazil, and Lisbon region, Portugal. Cien Saude Colet [Internet]. 2017 Mar;22(3):713–23.
22. Menger LM, Stallones L, Cross JE, Henry KL, Chen PY. Strengthening suicide prevention networks: Interorganizational collaboration and tie strength. Psychosoc Interv [Internet]. 2015 Dec;24(3):155–65.
23. Hansson J, Ovretveit J, Askerstam M, Gustafsson C, Brommels M. Coordination in networks for improved mental health service. Int J Integr Care. 2010;10(3):213–26.
24. Beers LS, Godoy L, Biel MG. Using Effective Public Private Collaboration to Advance Integrated Care. Child Adolesc Psychiatr Clin N Am. 2017 Oct;26(4):665–75.
25. Poochaoren O, Ting B. Collaboration , Coproduction , Networks – Convergence of Theories. Lee Kuan Yew Sch Public Policy Res Pap. 2014 Apr;No. 14-13(65):587–614.
26. Xia J, Rutherford S, Ma Y, Wu L, Gao S, Chen T, et al. Obstacles to the coordination of delivering integrated prenatal HIV, syphilis and hepatitis B testing services in Guangdong: using a needs assessment approach. BMC Health Serv Res. 2015 Mar;117(15):117–26.
27. Friedman SR, Reynolds J, Quan MA, Call S, Crusto CA, Kaufman JS. Measuring changes in interagency collaboration: An examination of the Bridgeport safe start initiative. Eval Program Plann. 2007 Aug;30(3):294–306.
28. Kartseva V, Hulstijn J, Gordijn J, Tan Y-H. Control patterns in a health-care network. Eur J Inf Syst. 2010 Jun;19(3):320–43.
29. Kitchenham B. Procedures for performing systematic reviews. Keele, UK, Keele Univ [Internet]. 2004;33(TR/SE-0401):28.
30. Kitchenham B, Charters S. Guidelines for performing Systematic Literature Reviews in Software Engineering. Engineering. 2007;2:1051.
31. Selden SC, Sowa JE, Sandfort JJJ. The impact of nonprofit collaboration in early child care and education on management and program outcomes. PUBLIC Adm Rev. 2006;66(3):412–25.
32. Ansell C. When collaborative governance scales up: Lessons from global public health about compound collaboration. Policy Polit. 2015 Jul;43(3):391–406.
33. Tranfield D, Denyer D, Smart P. Towards a methodology for developing evidence‐informed management knowledge by means of systematic review. Br J Manag. 2003;14(3):207–22.
34. Charmaz K, Belgrave LL. Grounded Theory. Blackwell Encycl Sociol [Internet]. 2015; Available from: http://doi.wiley.com/10.1002/9781405165518.wbeosg070.pub2
35. Van Dongen T, Sabbe B, Glazemakers I. A protocol for interagency collaboration and family participation: Practitioners’ perspectives on the Client Network Consultation. J Interprof Care [Internet]. 2018;32(1):14–23.
36. Bolland JM, Wilson J V. Three faces of integrative coordination: a model of interorganizational relations in community-based health and human services. Health Serv Res. 1994 Aug;29(3):341–66.
37. Junior NB, Shimizu HE. Theoretical reflections on governance in health regions. Cien Saude Colet. 2017 Apr;22(4):1085–95.
38. Alexander JA, Weiner BJ, Metzger ME, Shortell SM, Bazzoli GJ, Hasnain-Wynia R, et al. Sustainability of collaborative capacity in community health partnerships. Med CARE Res Rev. 2003 Dec;60(4, S):130S-160S.
39. Vining a R, Globerman S. Contracting-out health care services: a conceptual framework. Health Policy [Internet]. 1999;46(2):77–96.
40. Abebe GK, Chalak A, Abiad MG. The effect of governance mechanisms on food safety in the supply chain: Evidence from the Lebanese dairy sector. J Sci Food Agric. 2017 Jul;97(9):2908–18.
41. Lin BY-J, Lin Y-K, Lin C-C. Partnership effectiveness in primary community care networks: A national empirical analysis of partners’ coordination infrastructure designs. Health Care Manage Rev. 2010;35(3):224–34.
42. Alexander JA, Lee S-YYD, Bazzoli GJ. Governance forms in health systems and health networks. Health Care Manage Rev [Internet]. 2003;28(3):228–42.
43. Peters DTJM, Raab J, Greaux KM, Stronks K, Harting J. Structural integration and performance of inter-sectoral public health-related policy networks: An analysis across policy phases. Health Policy (New York). 2017 Dec;121(12):1296–302.
44. Lin BY-JJ. Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan. BMC Health Serv Res. 2007 Jun;7:1–15.
45. Beatty KE, Wilson KD, Ciecior A, Stringer L. Collaboration among missouri nonprofit hospitals and local health departments: Content analysis of community health needs assessments. Am J Public Health. 2015 Apr;105(2):S337–44.
46. Brito RP, Miguel PLS, Abdullah E, Idris A, Saparon A. Power, Governance, and Value in Collaboration: Differences between Buyer and Supplier Perspectives. J Supply Chain Manag. 2017 Apr;53(2):61–87.
47. Phillimore J, Klaas F, Padilla B, Hernández-Plaza S, Rodrigues V. Adaptation of Health Services to Diversity: An overview of approaches. IRiS Work Pap Ser No 15/2016. 2016;
48. Wong NWMM. The road to environmental participatory governance in Taiwan: collaboration and challenges in incineration and municipal waste management. J Environ Plan Manag [Internet]. 2017;60(10):1726–40.
49. Varda D, Shoup JA, Miller S. A Systematic Review of Collaboration and Network Research in the Public Affairs Literature: Implications for Public Health Practice and Research. Am J Public Health. 2012 Mar;102(3):564–71.
50. Casey DK, Lawless JS. The parable of the poisoned pork: Network governance and the 2008 Irish pork dioxin contamination. Regul Gov. 2011 Sep;5(3):333–49.
51. Kim K, Andrew SA, Jung K. Public Health Network Structure and Collaboration Effectiveness during the 2015 MERS Outbreak in South Korea: An Institutional Collective Action Framework. Int J Environ Res Public Health. 2017 Sep;14(9):16–35.
52. Gauld R. The theory and practice of integrative health care governance The case of New Zealand’s alliances. J Integr CARE [Internet]. 2017;25(1):61–72.
53. Parra DC, Dauti M, Harris JK, Reyes L, Malta DC, Brownson RC, et al. How does network structure affect partnerships for promoting physical activity? Evidence from Brazil and Colombia. Soc Sci Med. 2011 Nov;73(9):1365–70.
54. Mandal S. The influence of dynamic capabilities on hospital-supplier collaboration and hospital supply chain performance. Int J Oper Prod Manag. 2017;37(5):664–84.
55. Pfeiffer M, Vanya D, Davison C, Lkhagvasuren O, Johnston L, Janes CR. Harnessing opportunities for good governance of health impacts of mining projects in Mongolia: results of a global partnership. Global Health. 2017 Jun;13(1):13–39.
56. Sørensen E, Torfing J, Sorensen E, Torfing J. Metagoverning Collaborative Innovation in Governance Networks. Am Rev Public Adm. 2017 Oct;47(7):826–39.
57. Vargas I, Susana Mogollon-Perez A, De Paepe P, da Silva MR, Unger J-P, Vazquez M-L. Barriers to healthcare coordination in market-based and decentralized public health systems: a qualitative study in healthcare networks of Colombia and Brazil. Health Policy Plan. 2016 Jul;31(6):736–48.
58. Casanova AO, Cruz MM, Giovanella L, Alves G dos R, Pereira Cardoso GC. Health care networks implementation and regional governance challenges in the Legal Amazon Region: an analysis of the QualiSUS-Rede Project. Cien Saude Colet. 2017 Apr;22(4):1209–24.
