| 61. |
- Åhgren, Bengt
(författare)
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Mutualism and antagonism within organisations of integrated health care
- 2010
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Ingår i: Journal of Health Organization & Management. - 1477-7266 .- 1758-7247. ; 24:4, s. 396-411
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of this paper is to explore the concepts of Swedish integrated health care, their state of development and interdependence, and, furthermore, evaluate whether the theoretical framework used improves the comprehension of why integrated health care arrangements endure or cease.DESIGN/METHODOLOGY/APPROACH: The study is founded on descriptive data gathered from a literature search on integrated health care in Sweden. With inspiration from ecology theory, these data were analysed guided by a theoretical model based on a continuum of symbiotic effects, from antagonism to mutualism.FINDINGS: The era of Swedish integrated health care started in the 1990s, when a kind of clinical network called chains of care was launched. At the beginning the chain of care development was predominantly surrounded by non-integrative conditions, which had a restraining effect on these efforts. Even so, it seems that chains of care are here to stay. This faith in chains of care can to some extent be explained by the crucial role they have as connectors in the emerging local health care systems. Thus, these systems need chains of care to evolve and chains of care seem to require the integrative framework of local health care to progress and endure. Integrated health care performance could be troublesome, unless such mutualistic conditions are in place. States of commensalism may also be promoted, but the advantages are unilateral and therefore there is a risk of disloyalty by the unaffected part, which, in turn, can create a breeding-ground for an antagonistic liaison.ORIGINALITY/VALUE: A theoretical approach founded on what may be called "Health Care System Ecology" appears to enhance the understanding of the complex logic of integrated health care.
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| 62. |
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| 63. |
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| 64. |
- Åhgren, Bengt, 1950-
(författare)
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Patient choice and health care integration : a review of the consistency between two Swedish policy concepts
- 2010
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Ingår i: International Journal of Integrated Care.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Despite of an insignificant track record of quasi market models in Sweden, new models of this kind have recently been introduced in health care; commonly referred to as ‘choice of care’. This time citizens act as purchasers; choosing the primary care centre or family physician they want to be treated by, which, in turn, generates a capitation payment to the chosen unit. Policy makers believe that such systems will be self-remedial, that is, as a result of competition the strong providers survive while unprofitable ones will be eliminated. Because of negative consequences of the fragmented health care delivery, policy makers at the same time also promote different forms of integrated health care arrangements. One example is ‘local health care’, which could be described as an upgraded community-oriented primary care, supported by adaptable hospital services, fitting the needs of a local population. This paper reviews if it is possible to combine this kind of integrated care system with a competition driven model of governance, or if they are incompatible.Theory: Inter-organisational and interprofessional collaboration, accessibility of services, and provider continuity.Method: Literature-based review.Results and conclusions: The findings indicate that some choice of care schemes could hamper the development of integration in local health care. However, geographical monopolies like local health care, enclosed in a non-competitive context, lack the stimulus of competition that possibly improves performance. Thus, it could be argued that if choice of care and local health care should be combined, patients ought to choose between integrated health care arrangements and not among individual health professionals.
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| 65. |
- Åhgren, Bengt
(författare)
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The Art of Integrating Care : Theories Revisited
- 2012
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Ingår i: Open Public Health Journal. - 1874-9445. ; 5, s. 36-39
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Tidskriftsartikel (refereegranskat)abstract
- Integration of care is high on public health agendas all around the world. The development and implementation of integrative arrangements has been promoted for more or less two decades. Despite this every so often extensive history, there are recognised needs to take research into areas yet poorly explored, which include measures and outcomes of integrated care. On the other hand, existing evidence and knowledge can probably become more ennobled and thereby contribute to a deeper understanding of the compound art of integrating of health care services. Accordingly, the aim of this article is to re-evaluate and synthesise some revisited theories for the facilitation of sustainable integrated care solutions.This exploration shows it is important to have crucial prerequisites for integration in place: both functional and interactional conditions. This appears to be an organic process where the stakeholders go through gradual changes until the optimum level of integration as well as mutualistic interactions are established.It could be argued that refined knowledge could be excerpted from existing research. Then again, this strategy does not exclude actions for new research in poorly explored areas. Both approaches are important for the development of sustainable integrated care.
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| 66. |
- Åhgren, Bengt, 1950-
(författare)
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The mutualism between chains of care and local care
- 2008
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Ingår i: International Journal of Integrated Care – Vol. 8, 4 June 2008. ; , s. e13-
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionThere is a growing interest in compensating for the fragmented delivery of care by promoting integrated care. This movement is a feature of national and local policy, and it is being supported and encouraged amongst care providers.AimsDiscuss the concepts of Swedish integrated care and their impact on care delivery systems.ResultsThe chain of care concept is commonly regarded as a means to make a care delivery system better adapted to the needs of patients. In many county councils, this transformation is supported by policies focusing on quality and comprehensiveness. Despite several years of experience, a vast majority of the county councils regard themselves as unsuccessful in developing chains of care.In addition, many county councils have changed their delivery systems during recent years and implemented ‘Local Care’, an upgraded family- and community-oriented primary care supported by a flexible hospital system. It is unusual to find a high degree of organisational cohesiveness in the implementation of local care. Instead these solutions are in many cases supposed to be built on chains of care.ConclusionsChains of care are increasingly regarded as building stones of local care, which means that chains of care are embraced in a context and by conditions more favourable than former non-integrative care delivery systems. In this sense, chains of care may have a renaissance, after assuredly being high on the policy agendas but with several years of modest development results. Thus, local care needs chains of care to evolve and chains of care need the integrative framework of local care to sustain.
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| 67. |
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| 68. |
- Åhgren, Bengt, 1950-
(författare)
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Utvärdering av integration inom närsjukvård
- 2007
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Ingår i: Folkhälsa i samverkan mellan professioner, organisationer och samhällssektorer. - : Studentlitteratur AB. - 9789144017938 ; , s. 305-321
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 69. |
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| 70. |
- Åhgren, Bengt, 1950-
(författare)
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Whys and Wherefores of Integrated Health Care
- 2008
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Ingår i: Integrated Health Care Delivery. - : Nova Science Publishers, Inc.. - 9781604568516 - 1604568518 ; , s. 137-150
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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