Organisational and Professional Integration Between Specialist and Primary Healthcare Services: A Municipal Perspective
Autor: | Catharina Bjørkquist, Mona Jerndahl Fineide, Erna Haug |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Medicine (General)
Health (social science) coordination Sociology and Political Science Vulnerability Context (language use) integration Norwegian professional 03 medical and health sciences 0302 clinical medicine R5-920 medicine 030212 general & internal medicine Sociology organisational rainbow model Research and Theory business.industry 030503 health policy & services Health Policy Public relations Arbitrariness medicine.disease Mental health language.human_language Substance abuse language Normative The Conceptual Framework 0305 other medical science business |
Zdroj: | International Journal of Integrated Care, Vol 21, Iss 2 (2021) International Journal of Integrated Care International Journal of Integrated Care; Vol 21: April-June 2021; 21 |
ISSN: | 1568-4156 |
Popis: | Introduction: Care transitions between specialist and primary healthcare services for people with concurrent substance abuse and mental health problems are characterised by vulnerability and arbitrariness. Objectives: By studying factors that influence integration in a Norwegian context, this study aims to investigate, from a municipal perspective, why care transitions are still tricky after the introduction of the key Coordination Reform. Methods: This study has an explorative approach based on interviews with managers and front-line professionals in primary care. We applied the conceptual framework of functional and normative integration of the Rainbow Model. Results: The municipal actors emphasise that integration is hampered by limited cooperation with general practitioners in referrals to hospital, challenges of communication and loss of meeting points. They experienced close cooperation with sociomedical polyclinics for substance abuse, while challenges in cooperation with district psychiatric centres indicated an interdependence of functional and normative integration. Questioning hospital discharge of patients to primary care was a recurring theme for the municipal actors. Thus, the governing framework of the Coordination Reform has coexisted with fragmentation in organisational structures and divided professional cultures. Conclusions: The coexistence of the new and the old regimes seems to hamper functional and normative integration in care transitions. |
Databáze: | OpenAIRE |
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