With the increasing differentiation of organisations involved in the pursuit of public health, there is also a growing need for inter-organisational integration. Starting from the concepts of differentiation and integration, this article is attempting a theoretical reconstruction based on published research on inter-organisational integration in public health and related welfare services. Different forms of integration are defined and related to each other in a conceptual framework, which is in itself an integration of different theoretical perspectives. According to this framework, integration in the field of public health requires inter-organisational collaboration across different sectors of the society. Such intersectoral collaboration can be organised mainly in the form of multidisciplinary teams across the boundaries of different organisations and sectors. Such an organisation is fragile and volatile, however, which means that it needs a lot of management support in order to survive.

Integration and collaboration in public health—a conceptual framework

Introduction: Collaboration between welfare organizations is an important strategy for integrating different health and welfare services. This article reports a review of the international literature on vocational rehabilitation, focusing on different organizational models of collaboration as well as different barriers and facilitating factors. Methods: The review was based on an extensive search in scientific journals from 1995 to 2010, which generated more than 13,000 articles. The number of articles was reduced in different steps through a group procedure based on the abstracts. Finally, 205 articles were read in full text and 62 were included for content analysis. Results: Seven basic models of collaboration were identified in the literature. They had different degrees of complexity, intensity and formalization. They could also be combined in different ways. Several barriers and facilitators of collaboration were also identified. Most of these were related to factors as communication, trust and commitment. Conclusion: There is no optimal model of collaboration to be applied everywhere, but one model could be more appropriate than others in a certain context. More research is needed to compare different models and to see whether they are applicable also in other fields of collaboration inside or outside the welfare system.

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Organizational approaches to collaboration in vocational rehabilitation − An international literature review

Introduction: A project of vocational rehabilitation was studied in Sweden between 1999 and 2002 The project included four public organisations: the social insurance office, the local health services, the municipal social service and the office of the state employment service The aim of this paper was to analyse perceived barriers in the development of inter-organisational integration Theory: Theories of inter-professional and inter-organisational integration, and theories on organisational change Methods: In total, 51 semi-structured interviews and 14 focus group discussions were performed with actors within the project between 1999 and 2002 A thematic approach was used for the analysis of the data Results: Three different main themes of barriers emerged from the data: A Uncertainty, B Prioritising own organisation and C Lack of communication The themes are interconnected in an intricate web and hence not mutually exclusive Conclusions and discussion: The barriers found are all related partly to organisational change in general and partly to the specific development of organisational integration Prioritising of own organisation led to flaws in communication, which in turn led to a high degree of uncertainty within the project This can be seen as a circular relationship, since uncertainty might increase focus on own organisation and lack of communication A way to overcome these barriers would be to take the needs of the clients as a point of departure in the development of joint services and to also involve them in the development of inter-organisational integration

/pdf/barriers-of-inter-organisational-integration-in-vocational-3snm7xdw6s.pdf

Barriers of inter-organisational integration in vocational rehabilitation

The ever-growing industry of municipal solid waste (MSW) disposal appeals to the growing need for disposal facilities, and MSW treatment facilities are increasingly an environmental and public health concern. Residents living near MSW management facilities are confronted with various risk perceptions, especially odour. In this study, in an effort to assist responsible decision-makers in better planning and managing such a project, a structured questionnaire was designed and distributed to assess the nearby residents' concerns and attitudes surrounding the Laogang Landfill in Shanghai. Geographic information system techniques and relevance analysis were employed to conduct the spatial analysis of physical perceptions, especially odour annoyance. The findings of the research indicate that a significant percentage of the responding sample was aware of the negative impacts of landfills on the environment and public health, and residents in close proximity preferred to live farther from the landfill. The results from the spatial analysis demonstrated a definite degree of correlation between odour annoyance and distance to the facility and proved that the benefits of the socially disadvantaged have been neglected. The research findings also direct attention to the important role of public participation, information disclosure, transparency in management, and mutual communication to avoid conflicts and build social trust.

Residents' concerns and attitudes toward a municipal solid waste landfill: integrating a questionnaire survey and GIS techniques.

Decisions concerning entitlement to sickness benefits have a substantial impact on the lives of individuals and on society. In most countries, such decisions are made by staff of private or public insurance organisations. The work performed by these professionals is debated, hence more knowledge is needed on this subject. The aim of the present study was to review scientific studies of the practices of social insurance officers (SIOs) published in English, Danish, Norwegian and Swedish. Studies were searched for in literature databases, in reference lists, and through personal contacts. Analyses were made of type of study, areas investigated, research questions, theories used, and the results. Sixteen studies were included. SIOs and several other actors are responsible for applying measures to minimise sick-leave and promote return to work (RTW). The studies focusing on coordination of such measures revealed that SIOs felt unsure about how to handle their contacts with clients and other actors. One study indicated that the SIOs, partly due to lack of time, accepted the recommendations of physicians instead of making their own judgments about granting sickness benefits. While all SIOs must make decisions concerning entitlement to sickness benefits on a daily basis, few of the reviewed studies scrutinised the actual granting of sickness compensation. The studies were also deficient in that they investigated the decision latitude of the SIOs from a very limited perspective, mainly on an individual level and often primarily in relation to colleagues and/or clients rather than to the laws and regulations of the sickness insurance. The concepts and framework in this area of research need to be developed to facilitate elucidation of the interaction between different actors in local spheres, professionals in different disciplines, and between welfare staff and individual citizens.

Gatekeepers in sickness insurance: a systematic review of the literature on practices of social insurance officers.

Vocational rehabilitation targeted to the socially disadvantaged long-term sick requires that the client keep in touch with a number of welfare state agencies, all of which have different regulations, conflicting goals and various types of benefits. This is an arduous and time-consuming task for clients with medical, social and labour market problems. Many of these clients run the risk of ending up in a no-man's land or being endlessly circulated between agencies because their problems do not correspond to the profile of the typical client. Both government and welfare workers see institutional co-operation between welfare state agencies as the remedy to such problems. This article, which is based on interviews with participants in fourteen cooperating projects, focuses on difficulties and opportunities experienced in such co-operation. It is concluded that such co-operation, when initiated in local settings and supported by local players, is a way of rejuvenating the existing Swedish model.

Vocational rehabilitation of the socially disadvantaged long-term sick: inter-organizational co-operation between welfare state agencies.

Vocational rehabilitation of the socially disadvantaged long-term sick: inter-organizational co-operation between welfare state agencies: original article

Owe Grape

Papers

Vocational rehabilitation of the socially disadvantaged long-term sick: inter-organizational co-operation between welfare state agencies.

Vocational rehabilitation of the socially disadvantaged long-term sick: inter-organizational co-operation between welfare state agencies: original article