Dinamiche di collaborazione interospedaliera: un’analisi longitudinale nella regione Abruzzo

Journal title MECOSAN
Author/s Valentina Evangelista, Fausto Di Vincenzo
Publishing Year 2015 Issue 2014/92
Language Italian Pages 18 P. 9-26 File size 917 KB
DOI 10.3280/MESA2014-092002
DOI is like a bar code for intellectual property: to have more infomation click here

Below, you can see the article first page

If you want to buy this article in PDF format, you can do it, following the instructions to buy download credits

Article preview

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

This study analyzes the evolution of the collaborative network between the hospitals of the Abruzzo region between 2009 and 2011 using the Social Network Analysis theories and methods. The analysis shows that hospitals collaborate using an inherent memory consisting of the previous relations and of endogenous self-organizing mechanisms. Also the LHA membership, the number of staffed beds, the geographical distance from other hospitals, the percentage of admitted in emergency and the percentage of inappropriate hospital admissions affect the propensity of hospitals to cooperate. The implications for managers and policy makers are discussed.

Keywords: Inter-hospital collaboration, longitudinal analysis, Abruzzo

  1. Cicchetti A., Mascia D. (2007). Organizzare le reti in sanita: teoria, metodi e strumenti di Social Network Analysis. Mecosan, 61: 9-31.
  2. Barretta A. (2007). Il dualismo competizione/cooperazione fra aziende sanitarie pubbliche: un’analisi esplorativa. Mecosan, 61: 49-68.
  3. Barretta A. (2008). The functioning of co-opetition in the health-care sector: an explorative analysis. Scandinavian Journal of Management, 24(3): 209-220. DOI: 10.1016/j.scaman.2008.03.005
  4. Barretta A., Busco C. (2004). Competizione e cooperazione nel sistema sanitario: il ruolo della programmazione e del controllo nella creazione di una “cultura di area vasta”. Azienda Pubblica, 4: 71-92.
  5. Bazzoli G.J., Shortell S.M., Dubbs N., Chan C., Kralovec P. (1999). A taxonomy of health net works and systems: bringing order out of chaos. Health Services Research, 33(6): 1683-1717.
  6. Boari C., Grandi A., Lorenzoni G. (1989). Le organizzazione a rete: tre concetti di base. Economia e politica industriale, 64: 283-310.
  7. Brennan J.A., Allin D.M., Calkins A.M., Engudanos E.R., Heimbach L.J., Pruden J.N., Stilley D.G. (2000). Guidelines for ambulance diversion. Annals of Emergency Medicine, 36 (4): 376-377. DOI: 10.1067/mem.2000.110815
  8. Butera F. (1990). Il castello e la rete. Milano: FrancoAngeli. Casati G., Di Ghionno E., Di Vincenzo F., Ricci M.,
  9. Di Stanislao F. (2008). L’evoluzione dei sistemi di valutazione della performance dei servizi sanitari. Monitor, 20(1): 15-57.
  10. Catturi G. (1984). Lezioni di Economia Aziendale. Padova: Cedam.
  11. Cohen M.D., Hillgoss B., Kajdacsy-Balla Amatal A. (2012). A handoff is not a telegram: an understanding of the patient is co-constructed. Critical Care, 16(1): 303-308. DOI: 10.1186/cc10536
  12. Di Vincenzo F., Evangelista V., Masciarelli F. (2014). Social capital and proximity in network dynamics: A mixed method approach. Paper presentato alla DRUID Society Conference Copenhagen, 16-18 Giugno.
  13. Dyer J.H., Singh R. (1998). The Relational View: Cooperative Strategy and Sources of Interorganizational Competitive Advantage. The Academy of Management Journal, 23(4): 660-679. DOI: 10.5465/amr.1998.1255632
  14. Fatovich D.M., Nagree Y., Sprivulis P. (2005). Access block causes emergency department overcrowding and ambulance diversion in Perth, Western Australia. Emergency Medicine Journal, 22(5): 351-354. DOI: 10.1136/emj.2004.018002
  15. Ferre F., Lecci F., Longo F. (2011). Analisi comparativa delle traiettorie evolutive dei sistemi sanitari regionali. In: Cantu E. (a cura di). Rapporto Oasi 2011. Milano: EGEA, pp. 225-258.
  16. Foley M., Kifaieh N., Mallon W.K. (2011). Financial Impact of Emergency Department Crowding. Western Journal of Emergency Medicine,12(2): 192-197.
  17. Galaskiewicz J. (1985). Interorganizational Relations. Annual Review of Sociology, 11(1): 281-304.
  18. DOI: 10.1146/annurev.soc.11.1.281
  19. Gordon B.D., Asplin B.R. (2004). Using online analytical processing to manage emergency department operations. Academic emergency medicine, 11(11): 1206-1212. DOI: 10.1111/j.1553-2712.2004.tb00706.x
  20. Grandori A. (1997). An Organizational Assessment of Interfirm Coordination Modes. Organization Studies, 18(6): 897-925. DOI: 10.1177/017084069701800601
  21. Gugiatti A. (1996). Sistemi a rete e organizzazione dei servizi sanitari. In: AA.VV., Strategie e gestione delle reti di aziende sanitarie. Milano: EGEA, pp. 307-338.
  22. Hagtvedt R., Ferguson M., Griffin P., Jones G.T., Keskinocak P. (2009). Cooperative strategies to reduce ambulance diversion. Proceedings of the 2009 Winter Simulation Conference (WSC), pp. 1861-1874. DOI: 10.1109/wsc.2009.5429194
  23. Handel D.A., McConnell K.J. (2009). The financial impact of ambulance diversion on inpatient hospital revenues and profits. Academy of Emergency Medicine, 16(1): 29-33. DOI: 10.1111/j.1553-2712.2008.00242.x
  24. Iwashyna T.D., Christie J.D., Moody J., Kahn J.M., Asch. D.A. (2009). The Structure of Critical Care Transfer Networks. Medical Care, 47(7): 787-793. DOI: 10.1097/mlr.0b013e318197b1f5
  25. Iwashyna T.D. (2009b). Uncharted paths: hospital networks in critical care. Chest Journal, 135(3): 827-833. DOI: 10.1378/chest.08-1052
  26. Iwashyna T.D., Courey A.J. (2011). Guided transfer of critically ill patients. Current opinion in Critical Care, 17(6): 641-647. DOI: 10.1097/mcc.0b013e32834b3e55
  27. Johnsen M., Morrisey J.P., Calloway M. (1996). Structure and change in child mental health service
  28. delivery networks. Journal of Community Psychology, 24(3): 275-289. DOI: 10.1002/(sici)1520-6629(199607)24:3%3C275::aidjcop7%3E3.0.co;2-w
  29. Lee B.Y., McGlone S.M., Song Y., Avery T.R., Eubank S., Chang C., Bailey R.R., Wagener D.K., Burke D.S., Platt R., Huang S.S. (2011). Social Network Analysis of Patient Sharing Among Hospitals in Orange County, California. American Journal of Public Health, 101(4): 707-713. DOI: 10.2105/ajph.2010.202754
  30. Lega F. (2002). Gruppi e reti aziendali in Sanita. Milano: EGEA.
  31. Levine S., White P.E. (1961). Exchange as a Conceptual Framework for the Study of Interorganizational Relationships. Administrative Science Quartely, 5(4): 583-601. DOI: 10.2307/2390622
  32. Lomi A., Pallotti F. (2012). Relational collaboration among spatial multipoint competitors. Social Networks, 34(1): 101-111. DOI: 10.1016/j.socnet.2010.10.005
  33. Longo F. (2007). Incentivi e strumenti per l’inte grazione delle reti socio-sanitarie. Tendenze Nuove 4-5:533 -551.
  34. Lo Scalzo A., Donatini A., Orzella L., Cicchetti A., Profili S., Maresso A. (2009). Health care system in transition. Italy Health system review. Health Systems in Transition, 11(6): 1-21.
  35. Macinati F. (2004). Le relazioni interaziendali di collaborazione in sanita. Milano: FrancoAngeli.
  36. Mascia D., Di Vincenzo F. (2008). Misurare la competizione ospedaliera nel Ssn. Mecosan, 68: 45-63.
  37. Mascia D., Di Vincenzo F. (2011). Understanding Hospital Performance: The Role of Network Ties and Patterns of Competition. Academy of Management Proceedings, 10(1): 1-6. DOI: 10.5465/ambpp.2010.54494818
  38. Mascia D., Di Vincenzo F., Cicchetti A. (2012). Dynamic analysis of interhospital collaboration and competition: empirical evidence from an Italian regional health system. Health Policy, 105 (2-3):273-281. DOI: 10.1016/j.healthpol.2012.02.011
  39. Mascia D., Mucciconi A.F., Di Vincenzo F., Di Candia V. (2010). Collaborazione e competizione nel Servizio sanitario nazionale: evidenze empiriche nella Regione Abruzzo. Politiche Sanitarie, 11(4): 68-80.
  40. McConnell K.J., Richards C.F., Daya M., Weathers C.C., Lowe R.A. (2006). Ambulance diversion and lost hospital revenue. Annals of Emergency Medicine, 48(6): 702-710. DOI: 10.1016/j.annemergmed.2006.05.001
  41. Meneguzzo M. (2000). I terreni dell’innovazione organizzativa: le reti sanitarie ospedaliere e multiservizi. In: Bergamaschi M. (a cura di). L’organizzazione delle Aziende Sanitarie. Milano: McGrawHill.
  42. Milward H.B., Provan K.G. (1998). Measuring network structure. Public Administration, 76(2): 387-407. DOI: 10.1111/1467-9299.00106
  43. Ortiz J., Fottler M.D., Hofler R. (2005). Performance of Health Centers in Networks. Health Care Management Review, 32(2): 126-138. DOI: 10.1097/00004010-200504000-00007.PallottiF.,LomiA.(2011).Networkinfluenceandorganizationalperformance:Theeffectsoftiestrengthandstructuralequivalence.EuropeanManagementJournal,29(5):389-403.DOI:10.1016/j.emj.2011.02.005
  44. Palmieri A., Mascia D. (2008). Un’analisi organizzativa dei modelli istituzionali per l’integrazione sociosanitaria. Politiche Sanitarie, 9(2): 61-77. Pham J.C., Patel R., Millin M.G., Kirsch T.D., Chanmugam A. (2006). The effects of ambulance diversion: a comprehensive review. Academic Emer gency Medicine, 13(11): 1220-1227. DOI: 10.1197/j.aem.2006.05.024
  45. Powell W.W. (1998). Learning from collaboration: Knowledge and networks in the biotechnology and pharmaceutical industries. California Management Review, 40(3): 228-240. DOI: 10.2307/41165952
  46. Provan K.G. (1984). Interorganizational Cooperation and Decision Making Autonomy in a Consortium Multihospital System. Academy of Management Review, 9(3): 494-504. DOI: 10.5465/amr.1984.4279689
  47. Provan K.G., Nakama L., Veazie M.A., Teufel-Shone N.I., Huddleston C. (2003). Building community capacity around a chronic disease services through a collaborative network. Health Education and Behavior, 30(6): 646-662. DOI: 10.1177/1090198103255366
  48. Ramirez-Nafarrate A., Fowler J.W., Wu T. (2011). Design of centralized ambulance diversion policies using simulation-optimization. Proceedings of the 2011 Winter Simulation Conference (WSC), pp. 1251-1262. DOI: 10.1109/wsc.2011.6147846
  49. Ripley R., Snijders T.A.B., Boda Z., Voros A., Preciado P. (2014). Manual for RSiena, testo disponibile al sito: http://www.stats.ox.ac.uk/~snijders/siena/. (16 dicembre 2014).
  50. Ruef M., Scott W.R. (1998). A multidimensional model of organizational legitimacy: Hospital survival in changing institutional environments. Administrative Science Quartely, 43(4): 877-904. DOI: 10.2307/2393619
  51. Schermerhorn J.R. (1975). Determinants of Interorganizational Cooperation. The Academy of Management Journal, 18(4): 846-856. DOI: 10.2307/255382
  52. Schneider S., Zwemer F., Doniger A., Dick R., Czapranski T., Davis E. (2001). Rochester, New York a decade of emergency department overcrowding. Academic Emergency Medicine, 8(11): 1044-1050. DOI: 10.1111/j.1553-2712.2001.tb01113.x
  53. Snijders T.A.B., Steglich C.E.G., Van De Blunt G.G. (2010). Introduction to actor-based models for network dynamics. Social Networks, 32(1): 44-60. DOI: 10.1016/j.socnet.2009.02.004
  54. Snijders T.A.B. (2011). Statistical Model for Social Network Analysis. Annual Review of Sociology, 37: 131-153. DOI: 10.1146/annurev.soc.012809.102709
  55. Soda G. (1998). Reti tra imprese. Roma: Carocci. Soda G., Usai A., Zaheer A. (2004). Network memory: The influence of past and current network on performance. The Academy of Management Journal, 47(6): 893-906. DOI: 10.2307/20159629
  56. Sprivulis P., Gerrard B. (2005). Internet-accessible emergency department workload information reduces ambulance diversion. Prehospital Emergency Care, 9(3):285-291. DOI: 10.1080/1090312059096209
  57. Trinh H.Q., Begun J.W., Luke R.D. (2010). Better to receive than to give? Interorganizational service arrangements and hospital performance. Health Care Management Review, 35(1): 88-97. DOI: 10.1097/hmr.0b013e3181a93f8d
  58. Van De Ven A.H. (1976). On the Nature, Formation and Maintenance of Relations among Organizations. The Academy of Management Review, 1(4):
  59. 24-36. DOI: 10.2307/257722.VanRaakA.,PaulusA.(2001).Asociologicalsystemstheoryofinterorganizationalnetworkdevelopmentinhealthandsocialcare.SystemsResearchandBehavioralScience,18(3):207-224.DOI:10.1002/sres.389
  60. Van Raak A., Paulus A., Mur-Veeman I. (2005). Why do health and social care providers co–operate? Health Policy, 74(1): 13-23. DOI: 10.1016/j.healthpol.2004.12.006
  61. Williams B. (1989). Strutture formali e realta sociali. In: Gambetta D. (a cura di). Le strategie della fiducia. Torino: Einaudi, pp. 2-18.

  • Il contributo delle reti sanitarie "spontanee" al miglioramento degli outcome: opportunità e sfide nella prospettiva della progettazione dei sistemi di programmazione e controllo Vincenzo Vignieri, Carmine Bianchi, Astrid Pietrosi, Giuseppe Provenzale, in MECOSAN 109/2020 pp.83
    DOI: 10.3280/MESA2019-109005

Valentina Evangelista, Fausto Di Vincenzo, Dinamiche di collaborazione interospedaliera: un’analisi longitudinale nella regione Abruzzo in "MECOSAN" 92/2014, pp 9-26, DOI: 10.3280/MESA2014-092002