University of Twente Student Theses


Conceptualization of scale in the practice of integrated care

Veenstra, J. (2020) Conceptualization of scale in the practice of integrated care.

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Abstract:On what scale public-services should be organized is an often-discussed topic within the public-sector. Recently, researchers fed the discussion of “scale “in the practice of integrated care. What scale actual entails and how optimization could evolve by configuring scale properly are topics that are discussed. Logically, because currently the healthcare sector has a lack of resources and qualified personnel. There is thus a need to conceptualize scale properly so that it becomes clearer on how to create scale-advantages. We used the theoretical concepts of economies of scope and scale to identify how networks of integrated care could optimize. We have performed a literature review to explore how scale is used and applied in the scientific literature on public-service-delivery. Secondly, we were able to conceptualize three forms of scale in the practice of integrated care: volume, geographical and jurisdictional. We interviewed network coordinators about these scales and analyzed which values of integrated care were linked with the different scales. We can conclude that networks of integrated care are currently less concerned with optimization but are more concerned with overcoming jurisdictional barriers to arrange person centered care. Theories of economies of scope and scale explain that the environment where networks operate influence the likelihood of a successful network. More hierarchal orientated environments should result in networks where network participants share inputs and create scale-advantages more easily. Because the environment of the Dutch healthcare sector is not fully public nor fully private, it makes it more complex to share inputs as network participants.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:88 social and public administration
Programme:Public Administration MSc (60020)
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