Improving inter-organizational care-cure designs: specialization versus integration

Journal of Integrated Care, Ahead of Print. Purpose The purpose of this paper is to investigate inter-organizational designs for care –cure conditions in which low-risk patients are cared for in specialized care organizations and high-risk patients are cared for in specialized cure organizations. Performance impacts of increasing levels of integration between these organizations are analyzed. Design/methodology/approach Mixed methods were used in Dutch perinatal care: analysis of archival data, clinical research and system dynamics simulation modeling. Findings Inter-organizational design has an effect on inter-organizational dynamics such as collaboration and trust, and also on the operational aspects such as patient flows through the system. Solutions are found in integrating care and cure organizations. However, not all levels of integrated designs perform better than a design based on organizational separation of care and cure. Practical implications A clear split between midwifery practices (care) and obst etric departments (cure) will not work since all pregnant women need both care and cure. Having midwifery practices only works well when there are high levels of collaboration and trust with obstetric departments in hospitals. Integrated care designs are likely to exhibit superior performance. Howev er, these designs will have an adverse effect on organizations that are not part of this integration, since integrating only a subset of organizations will feed distr...
Source: Journal of Integrated Care - Category: International Medicine & Public Health Source Type: research