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

流动医疗服务提供者的合作网络：探索影响护理协调的机制

• 批准号: 416396249
• 负责人: Professor Dr. Michel Wensing
• 金额: --
• 依托单位: Abteilung Allgemeinmedizin und Versorgungsforschung
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2019
• 资助国家: 德国
• 起止时间: 2018-12-31 至 2022-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/416396249?language=en
• 关键词: Cooperation; networks; ambulatory; healthcare; providers

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.

背景资料：如果研究发现没有转化为实际实施的干预措施、技术或政策，那么对研究的投资就是浪费。然而，有压倒性的证据表明存在研究浪费。在医疗保健方面，实施战略的效果好坏参半，平均而言，效果中等。由于越来越多的患者患有复杂的慢性健康问题和医疗保健服务的持续专业化，实施科学需要考虑到许多患者从不同的医疗保健提供者那里接受医疗保健。该项目基于社交网络的视角，考虑医疗服务提供者和患者对合作网络的看法，探索哪些机制有助于医疗服务提供者之间的合作。目标：拟议研究项目的总体目标是探索医疗服务提供者的专业网络中的哪些机制有助于医疗保健的合作与协调。具体目标是：从患者和提供者的角度描述和探索专业网络的变化; B）探索哪些网络相关机制在合作和协调中发挥作用;假设的网络因素是意见领袖、中心护理提供者、网络密度、网络同质性、病例协调、网络互惠性和网络组成的变化。方法：基于申请人的试点研究，计划在现实环境中进行两项连续研究。1)一项针对医疗保健提供者网络的观察性研究，涉及来自40个全科诊所和大约320名医疗保健提供者的600名慢性（动脉粥样硬化相关）疾病患者。2)对56名医疗服务提供者和24名患者进行了定性访谈研究，并对10-15名利益相关者和专家进行了焦点小组研究，这两项研究都侧重于确定网络相关机制。前景：该项目将为机制提供知识，这是医疗保健合作和协调的基础。这将有助于设计创新的实施战略和措施的供应商网络，可用于未来的研究。