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1 – 10 of over 14000Leading health care institutions have recommended greater alignment among health care and social services organizations as a strategy to improve population health. Deepening our…
Abstract
Leading health care institutions have recommended greater alignment among health care and social services organizations as a strategy to improve population health. Deepening our understanding of how interorganizational relationships among health care and social service organizations influence care for people with complex needs could improve the design of interventions aimed at aligning these organizations to achieve health goals. Accordingly, we used qualitative methods to (1) elucidate the functions performed by health care and social service organizations caring for older adults and (2) investigate corresponding relationship forms. In-depth interviews with 175 representatives of health care and social service organizations in 10 communities were analyzed. Three distinct interorganizational relationships functions emerged: First, interorganizational relationships gave organizations a deeper and more accurate understanding of how their work was interdependent with the work of other organizations in the community. This function was achieved through coalitions that loosely tied large numbers of organizations and allowed information to flow among them. Second, interorganizational relationships allowed organizations to take joint action toward a shared goal, a function achieved in the form of pairs or small groups of organizations working closely together. Third, interorganizational relationships fostered accountability, with one organization advocating for the needs of clients or patients with another organization. Our results suggest that initiatives to promote regional alignment among health care and social services organizations may benefit from flexible models that anticipate a narrowing of partners to achieve tangible outcomes. Initiatives also need to accommodate low-level conflict that routinely exists among organizations in these sectors.
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Denise Alexander, Uttara Kurup, Arjun Menon, Michael Mahgerefteh, Austin Warters, Michael Rigby and Mitch Blair
There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health…
Abstract
There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.
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Anjali Ghosh and Eleni Koutsogeorgou
The aim of this chapter is to explore changes since the COVID-19 pandemic in welfare policies and services for people with learning disabilities and autism in England, focusing…
Abstract
The aim of this chapter is to explore changes since the COVID-19 pandemic in welfare policies and services for people with learning disabilities and autism in England, focusing mainly on educational and health and social care sectors.
A review of official policy documents published on GOV.UK from January 2020 to May 2021 has been conducted using keywords on the topic in question, and semi-structured interviews took place in 2022 with four key informants/stakeholders working in health and social care or education sectors of people with learning disability or autism in England.
The main findings indicate a need to shift practices online due to the pandemic, for both education and health and social-care practice. It is also clear that reforms and adjustments were implemented in guidance, policies and frameworks for the support of persons with learning disabilities and autism. It has been increasingly difficult for people with disabilities to access healthcare services and medication during the pandemic, and this has had an impact on their overall health and wellbeing too. Experts suggested that smoother changes and more support are required, in terms of provision of services, research, access to healthcare, educational services, mental health, employment, as well as more public funding on such services for people with learning disabilities and autism.
The main lessons learned were focusing on the use of online resources, digitalisation of services and access to them, but also difficulty of the system to adapt fast to major changes required in order to support people with disabilities.
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Genevra F. Murray and Valerie A. Lewis
While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to…
Abstract
While it has long been established that social factors, such as housing, transportation, and income, influence health and health care outcomes, over the last decade, attention to this topic has grown dramatically. Reforms that promote high-quality care as well as responsibility for total cost of care have shifted focus among health care providers toward upstream determinants of health care outcomes. As a result, there has been a proliferation of activity focused on integrating and aligning social and medical care, many of which depend critically on cross-sector alliances. Despite considerable activity in this area, cross-sector alliances in health care remain largely undertheorized. Both literatures stand to gain from more attention to carefully knitting together the theoretical and management literature on alliances with the empirical, health policy and health services literature on cross-sector alliances in health care. In this chapter, we lay out what exists in the current scientific literature as well as a framework for considering much needed work in this area. We organize the literature and our commentary around the lifecycle of alliances: alliance formation, including factors prompting alliance formation, partner selection, and alliance goals; alliance maturity, including the work of these cross-sector alliances, governance, finance and contracts, staffing structure, and rewards; and critical crossroads, including alliance timelines, definitions of success, and dissolution. We also lay out critical areas for future inquiry, including better theorizing on cross-sector alliances, developing typologies of these cross-sector health care alliances, and the role of policy in cross-sector alliances.
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Sociology promotes and describes public health, helping to explain macro-social dynamics of mental health care through studies of organizations, networks, and systems of care.
Abstract
Purpose
Sociology promotes and describes public health, helping to explain macro-social dynamics of mental health care through studies of organizations, networks, and systems of care.
Methodology/approach
This chapter summarizes sociological research on mental health care organizations and systems, illustrating a macro-social perspective by examining the problem of transitions in care for young adults. Summary findings from a regional mental health services research project describe a system of care that includes 100 organizations. This system helps young adults with mental health needs.
Findings
The scope and management of care involves a focus on modes of treatment supported by research evidence and delivered effectively by people with cultural competencies. Care and continuity of care are delivered through coordinated systems of inter-organizational networks, linking organizations and providers. Active inter-organizational linkages are needed to support mental health for young adults during challenging and sometimes difficult transitions.
Originality/value
This research summarizes original and regional data on mental health care organizations within a regional system of care. Practical implications include support for the importance of coordination, transition planning, and cultural competence within and among organizations. Sociological and original research on organizations and systems should continue to elaborate the needs and values of mental health services for regional planning and public health.
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In this chapter, I develop an analysis of the institutional logics which have shaped the organizational field of public sector mental health and which provide a framework for…
Abstract
Purpose
In this chapter, I develop an analysis of the institutional logics which have shaped the organizational field of public sector mental health and which provide a framework for understanding the complexities facing policy makers, providers, researchers, and community mental health advocates.
Approach
I first assess the current state of public sector mental health care. I then describe institutional theory, which focuses our attention on the wider social values and priorities (i.e., institutional logics) which shape mental health care. In the current post-deinstitutionalization era, there are three competing institutional logics: recovery and community integration, cost containment and commodification, and increased social control over those with severe mental disorders. Each of these logics, and the conflict between them, is explicated and analyzed. I then develop a theoretical framework for understanding how conflicting institutional logics are resolved. In the concluding section of this chapter, I offer some guidance to both researchers and advocates seeking meaningful system level reform.
Research implications
Researchers studying mental health policy need to understand how competing institutional logics work to shape the political climate, economic priorities, and types of services available.
Social implications
Advocacy is critical for meaningful reform, and a fourth institutional logic – that of social justice – needs to be developed by which to evaluate policy reforms and service offerings.
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Thomasina Borkman and Carol Munn-Giddings
Purpose – This research considers how self-help groups (SHGs) and self-help organizations (SHOs) contribute to consumerist trends in two different societies: United States and…
Abstract
Purpose – This research considers how self-help groups (SHGs) and self-help organizations (SHOs) contribute to consumerist trends in two different societies: United States and United Kingdom. How do the health care systems and the voluntary sectors affect the kinds of social changes that SHGs/SHOs make?
Methodology/approach – A review of research on the role of SHGs/SHOs in contributing to national health social movements in the UK and US was made. Case studies of the UK and the US compare the characteristics of their health care systems and their voluntary sector. Research reviews of two community level self-help groups in each country describe the kinds of social changes they made.
Findings – The research review verified that SHGs/SHOs contribute to national level health social movements for patient consumerism. The case studies showed that community level SHGs/SHOs successfully made the same social changes but on a smaller scale as the national movements, and the health care system affects the kinds of community changes made.
Research limitations – A limited number of SHGs/SHOs within only two societies were studied. Additional SHGs/SHOs within a variety of societies need to be studied.
Originality/value of chapter – Community SHGs/SHOs are often trivialized by social scientists as just inward-oriented support groups, but this chapter shows that local groups contribute to patient consumerism and social changes but in ways that depend on the kind of health care system and societal context.
Jessica Mills, Heather Baid, Alison Taylor and Tania Wiseman
The proposed chapter will focus on university partnerships for sustainable development, specifically in relation to the health and social care sector. As this is a burgeoning…
Abstract
The proposed chapter will focus on university partnerships for sustainable development, specifically in relation to the health and social care sector. As this is a burgeoning field of research and enterprise, this chapter would provide a valuable resource and much-needed exploration of how and with whom universities partner in terms of sustainability in health and social care.
The majority of universities have health sciences and social care departments delivering courses at undergraduate, postgraduate, and doctorate levels. As such, the chapter presents the range of opportunities for interdisciplinary learning and working, shares methods to foster social responsibility through partnerships between students, staff, clinicians, and service users, and acknowledges the prospect of lifelong learning that partnerships in sustainability can generate.
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Maria Brenner, Miriam O’Shea, Anne Clancy, Stine Lundstroem Kamionka, Philip Larkin, Sapfo Lignou, Daniela Luzi, Elena Montañana Olaso, Manna Alma, Fabrizio Pecoraro, Rose Satherley, Oscar Tamburis, Keishia Taylor, Austin Warters, Ingrid Wolfe, Jay Berry, Colman Noctor and Carol Hilliard
Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on…
Abstract
Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute–community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.
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At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public…
Abstract
At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.
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