Cooperation networks of ambulatory healthcare providers: exploration of mechanisms that influence coordination of care

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Background: Investments in research are wasted, if discoveries are not translated into interventions, technologies or policies, which are implemented in practice. Nevertheless, there is overwhelming evidence of research waste. In healthcare, the effects of implementation strategies have been mixed and, on average, moderate. Due to increasing numbers of patients with complex chronic health problems and ongoing specialisation in healthcare delivery, implementation science needs to take into account that many patients receive healthcare from different healthcare providers. Based on a social networks perspective, this project explores which mechanisms contribute to cooperation between healthcare providers, considering both the provider and the patient views on cooperation networks.Objectives: The overall aim of the proposed research project is to explore which mechanisms in the professional networks of healthcare providers contribute to cooperation and coordination of healthcare. Specific objectives are: a) to describe and explore variation in professional networks from the perspective of patients and providers; b) to explore which network-related mechanisms play a role in cooperation and coordination; Hypothesised network-factors are opinion leaders, central care providers, network density, network homogeneity, case coordination, network reciprocity, and change of network composition. Methods: Building on pilot studies of the applicant, two consecutive studies are planned in real-world settings. 1) An observational study of healthcare provider networks, involving 600 patients with chronic (atherosclerosis-related) disease from 40 general practices and approximately 320 healthcare providers. 2) Qualitative interview study with 56 healthcare providers and 24 patients, and a focus groups study with 10-15 stakeholders and experts, which are both focused on identifying network-related mechanisms. Perspective: The project will provide knowledge into mechanisms, which underlie cooperation and coordination of healthcare. This will contribute to the design of innovative implementation strategies and measures of provider-networks, which can be used in future research.