Integration and the Performance of Large-scale Health Enterprises: Field Studies of Psychological Health Delivery Systems in the U.S. Military
Name
Kamin, Cody M Integration and the performance of large-scale health enterprises.pdf
Size
9.93 MB
Format
Adobe PDF
Checksum (MD5)
97a30763b3216d72d66952cbcd66089c
Author(s)
Kamin, Cody M
Date Issued
May 23, 2016
Abstract
Large-scale health enterprises comprise multiple organizations that provide programs and services
for patients. Despite the interconnectedness of these systems there is a lack of empirical research
documenting how these organizations work collectively - or integrate - and how this integration
impacts enterprise performance measured through quality, efficiency, and access. In the case of
psychological healthcare, patients often require a number of services that span multiple
departments and programs within an enterprise, increasing the complexity of maintaining a
continuum of care for these patients. This paper, which is part of a larger effort to examine
psychological healthcare in the U.S. Military Health System, presents a series of qualitative
observations and analyses of the integration of psychological health-related organizations at two
large health enterprises within the military. These qualitative inquiries take a multilevel approach
for examining integration within these enterprises and address the following areas of interest:
1) the mechanisms for integration; 2) the objects of integration; 3) the dimensions of integration;
4) the contextual factors that influence integration; and 5) the impacts of integration on enterprise
performance. Using semi-structured interviews, qualitative data was collected and then examined
using content analysis to identify the most frequent themes for each area of interest. This data was
used to validate and refine a comprehensive framework for integration that was developed to pull
together multiple, distinct strands of the integration literature. This data was also used to
demonstrate the relationship between different dimensions of enterprise performance and to
identify areas where, in the process of optimizing enterprise performance, there is a trade-off
between these dimensions. The preliminary, qualitative results of this research are intended to
provide a conceptual foundation and framework for future analytic studies.
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