So Happy Together: A Scoping Review on Effectiveness of Inter-Organizational Care Delivery Networks

Abstract

While inter-organizational networks are widely recognized as a mode of organization to address the wicked problems in health care, we have a limited understanding of what makes these networks effective. This is imperative to keep health care delivery of high value (i.e. affordable and of high quality). In this study, we therefore performed a scoping review of the empirical literature that describes factors that influence the effectiveness of health care delivery networks. Our search yielded 3061 unique papers, of which 12 met our inclusion criteria. Much of the excluded literature studied different types of networks that did not seek to lower cost or improve quality, or lacked an explicit methodological approach. Included studies additionally lack robust theoretical foundation. Studies typically operationalize network effectiveness as a process measure, such as the degree of collaboration, rather than outcome measures. Furthermore, effectiveness is mostly measured as the perception of network members rather than actual goal attainment. Notably, coopting the operational level receives more attention in the health care literature, while the context remains underreported. To fully understand the factors influencing network effectiveness, there is need for more theoretically and methodologically robust research connecting perceived effectiveness, measured effectiveness, and the factors influencing network effectiveness.