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The Puzzle of Coherence-An ethnographic inspired study about cross-sectorial collaboration in Danish Health Care


Anne Bendix Andersen ,

Kirsten Beedholm,

Raymond Kolbæk,

Kirsten Frederiksen


Background: During the past decade, politicians and healthcare providers have strived to create a coherent healthcare system across primary and secondary healthcare sectors in Denmark. Nevertheless, elderly patients with chronic diseases (EPCD) continue to report experiences of poor-quality care and lack of coherence in treatment and patient pathways.

The aim:  of our study is to explore the role of healthcare providers in furthering coherence. Our ambition is to identify areas for improvement or change of collaborative practice between healthcare providers in municipalities, hospitals and general practice.

Method and material: Field observations were chosen as method for data collection because they allowed the researcher to follow the study participants in close proximity.

10 patients older than 65 years with multiple chronic diseases were followed through their patient pathways from admission to an acute care ward to discharge and later in meetings with healthcare providers in general practice, outpatient clinics, home care and physiotherapy.

Furthermore, field observations were conducted in general practice, home care and rehabilitation settings.

Research design: An explorative design based on an interactionistic approach was used. As a consequence, the focus of data collection is the production of meaning happening between human beings in social interaction in the field of cross-sectorial collaboration.

Research questions: The research questions reflect the interactionistic approach as they concentrate on identification and capturing of situations where participants in cross-sectorial collaboration interact with each other.

• How do healthcare providers act and communicate in the collaboration concerning EPCD?

• How do healthcare providers interact and communicate with EPCD?

• How is meaning produced in the interaction between actors representing different professional cultures?

Perspectives: Knowledge about the practice of cross-sectorial collaboration is crucial to the future planning of collaborating initiatives in health care. This study will generate new, valuable insight into the areas of cross-sectorial health care collaboration. Our findings may facilitate change in current practice and improve the quality and coherence in patient pathways of EPCD.

Findings from this study will be useful both nationally and internationally in preparation of health agreements, implementation of new collaboration forms among health care providers, and in improvement of delegation and transfer of information and assignments across sectors in health care.

The study runs from February 2015 till February 2018, where the PhD. thesis is submitted.

How to Cite: Bendix Andersen A, Beedholm K, Kolbæk R, Frederiksen K. The Puzzle of Coherence-An ethnographic inspired study about cross-sectorial collaboration in Danish Health Care. International Journal of Integrated Care. 2016;16(6):A59. DOI:
Published on 16 Dec 2016.


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