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Coordination between primary and secondary care: The role of electronic messages and economic incentives

La Rocca, Antonella; Hoholm, Thomas
Journal article, Peer reviewed
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URI
http://hdl.handle.net/11250/2434283
Date
2017
Metadata
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  • Scientific articles [1722]
Original version
BMC Health Services Research, 17(2017)149, 1-14   10.1186/s12913-017-2096-4
Abstract
Background

In Norway, a government reform has recently been introduced to enhance coordination between primary and secondary care. This paper examines the effects of two newly introduced measures to improve the coordination: an ICT-based communication tool/standard and an economic incentive scheme.

Method

This qualitative study is based primarily on 27 open-ended interviews. We interviewed nine employees at a hospital (the focal actor), 17 employees from seven different municipalities, and a representative of a Regional Health Authority.

Results

ICT-based communication is perceived to facilitate information exchange between primary and secondary care, thus positively affecting coordination. However, the economic incentive scheme appears to have the opposite effect by creating tensions between the two organizations and accentuating power asymmetry in favor of secondary care.

Conclusions

The inter-organizational nature of coordination in health care makes it crucial for policymakers and management of care organizations to conceive incentives and instruments that work jointly across organizations rather than at only one of the health care organizations involved. Such an approach is likely to favor a more symmetrical pattern of collaboration between primary and secondary care.
Description
This is an Open Access journal available from http://www.biomedcentral.com/
Publisher
BioMed Central
Journal
BMC Health Services Research

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