Abstract
BackgroundHealth care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness.MethodsThe study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for.ResultsNeither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors.ConclusionsAlthough the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness.
Highlights
Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care
We focus on two governance aspects of health care networks, i.e. governance structure and governance mechanisms, to answer questions such as: “Which kinds of governance exist in health care networks?”, and “Which kind of governance is assumed to be preferable for health care networks?” Provan and Kenis ([12]:231) explain that network governance “involves the use of institutions and structures of authority and collaboration to allocate resources and to coordinate and control joint actions across the network as a whole.”
This paper is an attempt to describe the networks in terms of governance structures and mechanisms, to learn which type of governance is used and whether we could find indications of a preferred type of governance
Summary
Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. Health care networks are inter-organizational collaborations among independent health care organizations or individual care professionals Such networks are widely accepted and used to provide integrated health care services [1]. Provan and Kenis [2] emphasize the need to study the networks as wholes, as entities in themselves rather than as a summation of dyad collaborations between two partners in a network. This entity is neglected as a level of analysis in network research and as a level of management in practice [2]. The work of McInnes et al [11] reveals the need for more research on conditions for network effectiveness, e.g. on whether networks with an informal structure and governance yield the same results as networks with a more formal form of governance
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