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BMC Health Services Research
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Coordination between primary and secondary care: the role of electronic messages and economic incentives

Authors: Antonella La Rocca, Thomas Hoholm

Published in: BMC Health Services Research | Issue 1/2017

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Abstract

Background

In Norway, a government reform has recently been introduced to enhance coordination between primary and secondary care. This paper examines the effects of two newly introduced measures to improve the coordination: an ICT-based communication tool/standard and an economic incentive scheme.

Method

This qualitative study is based primarily on 27 open-ended interviews. We interviewed nine employees at a hospital (the focal actor), 17 employees from seven different municipalities, and a representative of a Regional Health Authority.

Results

ICT-based communication is perceived to facilitate information exchange between primary and secondary care, thus positively affecting coordination. However, the economic incentive scheme appears to have the opposite effect by creating tensions between the two organizations and accentuating power asymmetry in favor of secondary care.

Conclusions

The inter-organizational nature of coordination in health care makes it crucial for policymakers and management of care organizations to conceive incentives and instruments that work jointly across organizations rather than at only one of the health care organizations involved. Such an approach is likely to favor a more symmetrical pattern of collaboration between primary and secondary care.
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Metadata
Title
Coordination between primary and secondary care: the role of electronic messages and economic incentives
Authors
Antonella La Rocca
Thomas Hoholm
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2096-4

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