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Leadership in integrated care networks: A literature review and opportunities for future research

Authors:

Matthias Mitterlechner ,

University of St. Gallen, CH
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Anna-Sophia Bilgeri,

University of St. Gallen, CH
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Johannes Rüegg-Stürm

University of St. Gallen, CH
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Abstract

Introduction and theoretical background: Our article offers a systematic review of research on leadership in integrated care networks. This review is timely as scholars and policy makers increasingly regard integrated care as a key part in reforming healthcare to cope with demographic aging, the rising prevalence of chronic diseases, and growing demand for long-term care. Although care integration can be accomplished via several governance modes including markets and hierarchies, elderly patients with chronic conditions often require a web of services delivered by multiple legally independent providers collaborating in inter-organisational networks. Given their growing importance, it is surprising how little we know about how integrated care networks are actually led. Amelung et al. (2017) note that “Leadership is certainly one of the neglected topics in integrated care” (p. 221). At the same time, several scholars have pointed to the pivotal role of leadership in networks, arguing that network formation is not only a strategic, but also a leadership issue (e.g, Sydow et al. 2017). Against this background, this paper reviews central characteristics of leadership in integrated care networks and outlines possible avenues for future research.

Theory/Methods: In this paper,we draw on generally accepted guidelines for conducting systematic reviews. In a first step, we define the key terms used in the paper – integrated care, networks, and leadership – to establish common understanding and specify the conceptual boundaries guiding the review. In a second step, we provide details on how we accessed the literature, defined inclusion criteria, and reviewed extant research. We eventually identify 58 journal articles that corresponded to our definition of leadership in integrated care networks and thus constitute the core sample of our review.

Results: Our systematic literature review suggests that research on leadership in integrated care networks can be organised into a two-dimensional matrix. On the one hand, research has emphasised the key role played by leadership processes (e.g. ways of communicating and deciding in networks) and leadership structures (e.g. financing regimes, budget rules, network size). On the other hand, researchers have analysed leadership processes and structures at different levels, including the network itself, the organisational field (policy) level, and the level of network member organisations.

Discussion and Conclusion: Our paper provides a systematic review of what we currently know about leadership in integrated care networks. Future work could usefully explore how leadership processes and leadership structures interact over time, examining more or less effective leadership practices underlying the emergence and evolution of integrated care networks. Another promising area for future research would be to investigate how leadership processes and leadership structures interact not only within but also across levels.

Contribution: This paper contributes to the literature on integrated care and current gaps in our understanding of leadership in integrated care networks (Amelung et al. 2017, Sydow et al. 2017).

Limitations: The findings are limited by our definitions of key terms and inclusion criteria (e.g., we decided to include only high-ranked peer-reviewed journal articles in English language).

 

How to Cite: Mitterlechner M, Bilgeri A-S, Rüegg-Stürm J. Leadership in integrated care networks: A literature review and opportunities for future research. International Journal of Integrated Care. 2019;19(4):128. DOI: http://doi.org/10.5334/ijic.s3128
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Published on 08 Aug 2019.

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