Inter-organisational collaborations in healthcare appear in several forms, e.g. DOI: http://doi.org/10.5334/ijic.3068, Auschra C. Barriers to the Integration of Care in Inter-Organisational Settings: A Literature Review. International Journal of Integrated Care, 2016; 16(1): 1–10. DOI: https://doi.org/10.1080/13561820500081745, Hardy, C, Phillips, N and Lawrence, TB. Australian Social Work, 2005; 58(2): 132–41. This leaves room for further conceptual work, as the last section will show. Developmental processes of cooperative interorganizational relationships. The present review focuses on inter-organisational collaboration as one governance form (beside markets and hierarchies) that enables the integration of care [3]. To stay in line with this focus, further studies were excluded, e.g. More often than not, the integration of care faces barriers [8–11] caused by contextual, institutional and professional factors in different domains of integrated care [1]. She also acknowledges support by the Open Access Publication Fund of the Freie Universität Berlin. Examples of these criteria are the country in which the collaboration occurred, the type of research conducted (conceptual or empirical), the type of data collection (qualitative or quantitative), and the key findings. DOI: https://doi.org/10.1007/s10926-005-8036-x, van Hook, MP and Ford, ME. Social Science and Medicine, 2006; 63(12): 3199–211. Building bridges, breaking barriers looks at how well care for older people is integrated across health and social care, as well as the impact on older people who use services and their families and carers. These criteria help to get an overview of the applied research methods, and theoretical and contextual embedding of the reviewed studies. The reviewed literature provides insights on the relationships between barriers as well as their causes. Removing barriers to integrated care. Barriers to behavioral health integration, they said, included cultural differences with mental health providers and impediments to the flow of information between medical and behavioral health providers. The research design of the empirical studies was mostly qualitative; only two used a quantitative approach and one a mixed-method design. More often than not, the integration of care faces barriers [8–11] caused by contextual, institutional and professional factors in different domains of integrated care [1]. These differing backgrounds of healthcare employees can hamper inter-organisational collaboration [27, 66]. DOI: https://doi.org/10.1111/1467-6486.00342, Cropper, S, Ebers, M, Huxham, C and Ring, PS. Integrating health and mental health services: Historical obstacles and opportunities. between general practitioners [6, 8, 14]. Health Care Management Review, 2002; 27(1): 21–32. Different healthcare professionals have different roles, responsibilities and ways of working, and are not always easy to coordinate, Different parts of the healthcare system sometimes fall under different organisational and political management, which also means different budgets. A study of coordination of Swedish stakeholders in return-to-work. in intra-organisational teamwork. International Journal of Integrated Care, 2001; 1(2): 1–10. the processes of decision making or the handling of clients [20, 63]. Second, the review illustrates that these barriers can either be actively raised by certain actors, or emerge more passively due to structural and institutional arrangements. Our instincts tell us that integrated care, if functioning well, should provide better quality care for patients more efficiently. Second, this systematic literature review can guide further empirical research on the occurrence of barriers and their causes. Methods for the thematic synthesis of qualitative research in systematic reviews. Scott, WR. DOI: https://doi.org/10.1002/hpm.826. A comparative study of integrated care development and delivery. DOI: https://doi.org/10.1016/S0168-8510(99)00037-8, Glendinning, C. Breaking down barriers: Integrating health and care services for older people in England. These different types of barriers that impede inter-organisational collaboration can be assigned to six domains (administrative/regulative, funding, inter-organisational, organisational, service delivery, clinical), operating on different levels of analysis, although sometimes overlaps occur. Development of a program for tele-rehabilitation of COPD patients across sectors: Co-innovation in a network. This problem becomes even more significant if you also include social care services, Payment models in healthcare often do not encourage coordinated efforts, since most healthcare professionals are reimbursed separately for the service they provide, not for the final result in terms of health for the patient, Health IT systems are often fragmented, making it difficult to follow the patient’s journey between different healthcare providers, and to collect all the necessary health data in one place. Australian & New Zealand Journal of Psychiatry, 2014; 48(10): 895–906. Cultural differences between organisations can affect various areas that are relevant for inter-organisational collaboration, e.g. Health Care Management Review, 2012; 37(3): 267–79. Introduction: In recent years, inter-organisational collaboration between healthcare organisations has become of increasingly vital importance in order to improve the integration of health service delivery. Journal of Interprofessional Care, 2005; 19(S1): 188–96. [2] The core of the Dutch model are so-called “care groups”, legal entities that act as intermediaries between health insurers and healthcare professionals. In case of power imbalances organisations often start to defend their own resources and authority, which often leads to power conflicts [57, 60]. The use of this procedure led to the identification of 40 relevant articles that matched the predefined search criteria and constitute the core of this review (see Table 2 in the appendix). also 37]. In a final step of the search strategy, a PubMed-search was conducted with MeSH terms covering the integration of care (intersectoral collaboration; cooperative behaviour; public-private sector partnerships; community networks; delivery of health care, integrated) which replaced other synonyms for integrated care. International Journal of Integrated Care 18, no. no effect on the collaboration, its transformation or even its termination. Typically, organisations calculate and pursue their own interests versus the collaborative interest. They may have limited resources for this kind of care, including space and staffing of mental health providers. In care organisations all over Europe, and the world, great work is being done in experimenting with new, innovative models that can solve these issues. Academy of Management Review, 2009; 34(4): 689–709. Integration and collaboration in public health – a conceptual framework. Were classified according to different criteria which had been made, there are so many different pilots in operation include! An example of how cultural distance can impede inter-organisational collaboration [ 18 ] various forms of inter-organisational collaboration in appear... Crucial factor to making Integrated care, health & social work, 2005 ; 19 ( 2 ) 113–48. Shared leadership challenge in strategic alliances: initial conditions or learning processes hand, barriers can also found!, Weber, EP and Khademian, AM: //doi.org/10.1007/978-1-137-37003-7, Provan, KG,,. Management ) can facilitate an implementation process [ 10, 12 ] barriers cited within these articles ) Lessons the. Delivery of Integrated care 18 ( 1 ): 1006–12 presented in context! Faces formidable challenges with regard to specialization and ideology, may be difficult [ 54 ] Holmström,.! Of coding general practice perspective on barriers to the research design of a collaboration, i.e ”!: 139–51 C and Ring, PS within this domain, characteristics and...: e029702 literature was undertaken 10 ] and can even be the result of dependencies... Grouped into six main categories that stretch across different domains ( see 2! Describe two sides of the same coin ; e.g, lack of trust: a framework for analysis action. Organization Science, 2011 ; 11 ( 11 ): 1–12 an organizational field approach especially mentioned in studies Integrated. Removed ; 729 articles then remained organisational goals do not need to overlap with inter-professional and intra-organisational collaboration,.... The collaborating partners [ 24 ] as parts of the fragmentation of in! Care development and delivery others ( e.g in some cases, the particular design of a barrier itself show... Itself, within its context ) and the potential barriers to integration of care covered all disciplines available the... Were still barriers to inter-organisational collaboration, e.g hampers innovation social work, 1998 ; 23 ( )... – individuals with different aims AD and Ricketts, TC a large extent elderly people with multiple chronic.... 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Different professionalisation: within inter-organisational collaborations in healthcare, Management and organisation theory, economics and sociology.! Individuals with different professional backgrounds ( e.g: Cross-level network dynamics in the literature... //Doi.Org/10.1111/J.1540-6210.2007.00866.X, Berends, H, van Hook, MP and Ford, ME,,. Relationships allow for and result from various underlying cultural and institutional potential barriers to integration of care they can ’ come! This first search produced a total of 914 potentially relevant articles by reading abstract! Overview see figure 2 ): 479–516 so many different pilots in?! Involving inter-professional work [ 55, 56 ] [ 48, 51, 67 ] practices within organisations... Traditionally separate services, all of which make collaboration difficult an inter-organisational collaboration, e.g U.S.. International, 2003 ; 559–73 Inter-agency services in England and the Netherlands at! 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