Decision-Making Dilemmas within Integrated Care Service Networks

The diverse nature of people’s care needs requires collaboration between different organisations and sectors. One way of achieving such collaboration is through integrated care service networks. A team of Vilans researchers conducted a systematic literature review of eighteen empirical studies in which decision-making dilemmas in integrated care service networks were inductively identified. 

In the literature review, published in the International Journal of Integrated Care (IJIC), three main patterns of decision-making dilemmas were identified within a diverse range of integrated care service networks across the world. The identified decision-making dilemmas included; autonomy versus inter-dependence;  diversity versus coherence, and self-interest versus common goals.

Establishing aligned and cohesive decision making often involves long-term processes. It takes time to cultivate collaborations in which diverging interests, goals, roles, interdependencies, commitment, power levels, and relationships are sorted out. To achieve the holistic care services that many people desire there is an increasing need to align care services of providers from different organisations, domains and/or sectors. These joint efforts call for active consideration of which forms of governance are effective or suitable.

Decision-making is an important aspect of governance but receives little explicit attention in the integrated care literature. In this literature review we shed light upon decision-making dilemmas that arise within complex, long-term processes to integrate (more) care services.

Authors: Jessica Michgelsen , Ludo M. Glimmerveen, Carina A. C. M. Pittens, Mirella M. N. Minkman