Concept of health care network and its key characteristics: a scoping review

Nakata, Liliane Cristina; Feltrin, Aline Fiori dos Santos; Chaves, Lucieli Dias Pedreschi; Ferreira, Janise Braga Barros

Liliane Cristina Nakata

Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.

http://orcid.org/0000-0002-7590-3365

Aline Fiori dos Santos Feltrin

Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.

http://orcid.org/0000-0001-5131-9116

Lucieli Dias Pedreschi Chaves

Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Geral e Especializada. Ribeirão Preto, SP, Brasil.

http://orcid.org/0000-0002-8730-2815

Janise Braga Barros Ferreira

Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Social. Ribeirão Preto, SP, Brasil.

http://orcid.org/0000-0001-7480-937

Corresponding author:Janise Braga Barros Ferreira E-mail: janise@fmrp.usp.br

AUTHORS’ CONTRIBUTIONS

Design of the review study. Data acquisition and analysis and interpretation of results. Writing and critical review of the manuscript. Approval of the article’s final version. Responsibility for all aspects of the content and for the integrity of the published article. Liliane Cristina Nakata. Aline Fiori dos Santos Feltrin. Janise Braga Barros Ferreira.

Interpretation of results and critical review of the manuscript. Approval of the article’s final version. Responsibility for all aspects of the content and for the integrity of the published article. Lucieli Dias Pedreschi Chaves.

ASSOCIATE EDITOR

Stela Maris de Mello Padoin

Databases	Strategy	Number of articles
Pubmed	(((((“Health Services”[Mesh:NoExp]) OR “Delivery of Health Care, Integrated”[Mesh:NoExp]) OR “Delivery of Health Care”[Mesh:NoExp]) OR “Health Promotion”[Mesh:NoExp]) OR “Regional Health Planning”[Mesh:NoExp]) OR “Health Systems Plans”[Mesh] AND “Health Care Networks” Filters: From 1990/01/01 to 2017/12/31, Spanish, Portuguese, English.	47
Scopus	(TITLE-ABS-KEY ((“Health Services” OR “Health Care Delivery, Integrated” OR “Health Care Delivery” OR “Health Promotion” OR “National Health Programs” OR “Health Systems Plans” OR “Regional Health Planning”)) AND TITLE-ABS-KEY (“Health Care Networks”)) AND PUBYEAR > 1989 AND (LIMIT-TO (DOCTYPE, “ar”) OR LIMIT-TO (DOCTYPE, “re”) OR LIMIT-TO (DOCTYPE, “cp”) OR LIMIT-TO (DOCTYPE, “ip”)) AND (LIMIT-TO (LANGUAGE, “English”) OR LIMIT-TO (LANGUAGE, “Portuguese”) OR LIMIT-TO (LANGUAGE, “Spanish”))	200
Lilacs	(“servicos de saude” (health services) or “atencao a saude” (health care) or “regionalizacao” (regionalization) or “promocao da saude” (health promotion) or “assistencia a saude” (health assistance)) [Subject descriptor] and redes (networks) [Words] and “1990” or “1991” or “1992” or “1993” or “1994” or “1995” or “1996” or “1997” or “1998” or “1999” or “2000” or “2001” or “2002” or “2003” or “2004” or “2005” or “2006” or “2007” or “2008” or “2009” or “2010” or “2011” or “2012” or “2013” or “2014” or “2015” or “2016” or “2017” [Country, year of publication]	549
CINAHL	(MH “Health Services”) OR (MH “Health Care Delivery, Integrated”) OR (MH “Health Care Delivery”) OR (MH “Health Promotion”) OR (MH “National Health Programs”)) AND “Health Care Networks”	24

	Title	Authors	Type of Study	Type of Document	Year	Country of Origin
1	Building legitimacy and the early growth of health networks for the uninsured.	Provan KG, Lamb G, Doyle M.¹⁶16 Provan KG, Lamb G, Doyle M. Building legitimacy and the early growth of health networks for the uninsured . Heal Care Manag. [Internet]. 2004; [citado 2017 Nov 10];29(2)117-28. Disponível em: http://www.scopus.com/inward/record.url?eid=2-s2.0-84877320913&partnerID=tZOtx3y1	Review	Scientific Paper	2004	United States
2	Integralidade da atenção e integração de serviços de saúde: desafios para avaliar a implantação de um “sistema sem muros” [Comprehensive health care and integrated health services: challenges for evaluating the implementation of a “system without walls”]	Hartz ZM, Contandriopoulos AP.¹⁷17 Hartz ZM A, Contandriopoulos A-P. Integralidade da atenção e integração de serviços de saúde: desafios para avaliar a implantação de um “sistema sem muros”. Cad Saúde Pública. 2004;20(Supl 2),331-6. http://dx.doi.org/10.1590/S0102-311X2004000800026. http://dx.doi.org/10.1590/S0102-311X2004...	Review/Theorization	Scientific Paper	2004	Brazil
3	Organizing the public health-clinical health interface: Theoretical bases	St-Pierre M, Reinharz D, Gauthier JB.¹⁸18 St-Pierre M, Reinharz D, Gauthier JB. Organizing the public health-clinical health interface: theoretical bases. Med Health Care Philos. 2006;9(1):97-106. http://dx.doi.org/10.1007/s11019-005-3602-8. http://dx.doi.org/10.1007/s11019-005-360...	Review/Theorization	Scientific Paper	2006	Canada
4	Understanding power relationships in health care networks	Addicott R, Ferlie E.¹⁹19 Addicott R, Ferlie E. Understanding power relationships in health care networks. J Health Organ Manag. 2007;21(4-5):393-405. http://dx.doi.org/10.1108/14777260710778925. http://dx.doi.org/10.1108/14777260710778...	Case study	Scientific Paper	2007	United Kingdom
5	Health care networks	Mendes EV.⁵5 Mendes EV. As redes de atenção à saúde. Cien Saude Colet. 2010;15(5):2297-305. http://dx.doi.org/10.1590/S1413-81232010000500005. http://dx.doi.org/10.1590/S1413-81232010...	Review/Theorization	Scientific Paper	2010	Brazil
6	Mejora de los cuidados crónicos a través de las Redes Integradas de Servicios de Salud [Improving Chronic Illness Care through Integrated Health Service Delivery Networks]	Barceló A, Luciani S; Agurto I, Ordúñez P, Tasca R, Sued O, Organización Panamericana de la Salud.²⁰20 Barceló A, Luciani S, Agurto I, Ordúñez P, Tasca R, Sued O. Mejora de los cuidados cronicos a traves de las redes integradoras de servicios de salud. Buenos Aires: Organizacion Panamericana de la Salud – OPS; 2012. 34 p.		Technical Document	2012	United States
7	Transformando los servicios de salud hacia redes integradas: elementos esenciales para fortalecer un modelo de atención hacia el acceso universal a servicios de calidad en la Argentina [Transforming health services into integrated networks: Essential elements to strengthen a model of care for universal access to high-quality services in Argentina]	Artaza Barrios O, coordenador, Organización Panamericana de la Salud.²¹21 Artaza Barrios O, coordenador. Transformando los servicios de salud hacia redes integradas: elementos esenciales para fortalecer un modelo de atención hacia el acceso universal a servicios de calidad en la Argentina. Buenos Aires: Organización Panamericana de la Salud - OPS; 2017. 90 p.		Technical Document	2017	Argentina
8	Redes de atenção à saúde: contextualizando o debate [Health care networks: Contextualizing the debate]	Kuschnir R, Chorny, AH.²²22 Kuschnir R, Chorny AH. Redes de atenção à saúde: contextualizando o debate. Cien Saude Colet. 2010;15(5):2307-16. http://dx.doi.org/10.1590/S1413-81232010000500006. http://dx.doi.org/10.1590/S1413-81232010...	Literature Review	Scientific Paper	2010	Brazil
9	Redes interfederativas de saúde: um desafio para o SUS nos seus vinte anos [Interfederal health networks: a challenge to SUS in its twentieth year]	Santos L, Andrade LOM.²³23 Santos L, Andrade LOM. Interfederal health networks: a challenge to SUS in its twentieth year. Cien Saude Colet. 2011;16(3):1671-80. http://dx.doi.org/10.1590/S1413-81232011000300002. http://dx.doi.org/10.1590/S1413-81232011...	Literature Review	Scientific Paper	2011	Brazil
10	Redes de atención GES y no GES [GES* and non-GES health care networks] *GES = Explicit Health Guarantees	Chile. Ministerio de Salud. Subsecretaría de Redes Asistenciales. División de Gestión de Redes Asistenciales. Departamento de Gestión de Garantías Explícitas en Salud.²⁴24 Chile. Ministerio de Salud. Subsecretaría de Redes Asistenciales. División de Gestión de Redes Asistenciales. Departamento de Gestión de Garantías Explícitas en Salud. Redes de atención ges y no ges [Internet]. Santiago: Ministerio de Salud; 2013. 122 p. Disponível em: http://hospitalclinicomagallanes.cl/documentos/ges/REDES-2013.pdf http://hospitalclinicomagallanes.cl/docu...		Technical Document	2013	Chile

	Concept of Network	Country of Origin	Key characteristics
1	Network utilized to describe cooperative arrangements between autonomous providers that are voluntary and not necessarily permanent but which may become increasingly formalized over time, whose integration of services can be extremely helpful and beneficial both to the provider organizations and to their patients and clients.¹⁶16 Provan KG, Lamb G, Doyle M. Building legitimacy and the early growth of health networks for the uninsured . Heal Care Manag. [Internet]. 2004; [citado 2017 Nov 10];29(2)117-28. Disponível em: http://www.scopus.com/inward/record.url?eid=2-s2.0-84877320913&partnerID=tZOtx3y1	United States	Integration Cooperation Formalization
2	Care delivery networks as an organization to achieve integrality, recognizing the interdependence of actors and organizations, in view of the fact that none of them has all the necessary resources and competencies to solve the health problems of a population in its different life cycles.¹⁷17 Hartz ZM A, Contandriopoulos A-P. Integralidade da atenção e integração de serviços de saúde: desafios para avaliar a implantação de um “sistema sem muros”. Cad Saúde Pública. 2004;20(Supl 2),331-6. http://dx.doi.org/10.1590/S0102-311X2004000800026. http://dx.doi.org/10.1590/S0102-311X2004...	Brazil	Integrality Interdependence Rationality
3	Network as the provision of various health care services in a more integrative manner in order to better meet the growing needs of patients and the general public.¹⁸18 St-Pierre M, Reinharz D, Gauthier JB. Organizing the public health-clinical health interface: theoretical bases. Med Health Care Philos. 2006;9(1):97-106. http://dx.doi.org/10.1007/s11019-005-3602-8. http://dx.doi.org/10.1007/s11019-005-360...	Canada	Integration Variety of services
4	Linked groups of health professionals and organisations from primary, secondary and tertiary care working together in a coordinated manner, unconstrained by existing professional (and organisational) boundaries to ensure equitable provision of high quality effective services.¹⁹19 Addicott R, Ferlie E. Understanding power relationships in health care networks. J Health Organ Manag. 2007;21(4-5):393-405. http://dx.doi.org/10.1108/14777260710778925. http://dx.doi.org/10.1108/14777260710778...	United Kingdom	Interconnection Cooperation Coordination Effectiveness Equity Quality
5	Health care networks are polyarchic organizations of sets of health services, connected to each other by a single mission, by common objectives and by cooperative and interdependent action, which enable to offer continuous and comprehensive care to a given population, coordinated by primary care - provided at the right time, in the right place, with the right cost, with the right quality and in a humanized way -, and with public health and economic responsibilities for this population.⁵5 Mendes EV. As redes de atenção à saúde. Cien Saude Colet. 2010;15(5):2297-305. http://dx.doi.org/10.1590/S1413-81232010000500005. http://dx.doi.org/10.1590/S1413-81232010...	Brazil	Cooperation Integrality Efficiency Defined territory Interdependence Coordination Quality Humanization Variety of services Common objective
6	Integrated health service delivery networks are understood as a group of organizations that provide or arrange equitable and integrated health services for a defined population. These networks are comprehensive, which means they provide services that cover all prevention levels in a coordinated way, integrated into all care levels and care provision units.²⁰20 Barceló A, Luciani S, Agurto I, Ordúñez P, Tasca R, Sued O. Mejora de los cuidados cronicos a traves de las redes integradoras de servicios de salud. Buenos Aires: Organizacion Panamericana de la Salud – OPS; 2012. 34 p.	Latin America Pan American Health Organization	Integration Integrality Defined territory Equity Longitudinality
7	Integrated Health Service Delivery Networks (RISS) are a “[…] set of organizations that provide health services in a coordinated, comprehensive and equitable way for a defined population, willing to account for their clinical and financial results and for the health status of the population they serve”. These networks require a series of special attributes to guarantee the fulfilment of the right to health, by means of comprehensive actions with and to communities and people, guaranteeing access, opportunity, continuity of care and high-quality assistance.²¹21 Artaza Barrios O, coordenador. Transformando los servicios de salud hacia redes integradas: elementos esenciales para fortalecer un modelo de atención hacia el acceso universal a servicios de calidad en la Argentina. Buenos Aires: Organización Panamericana de la Salud - OPS; 2017. 90 p.^:22	Argentina	Efficiency Integrality Defined territory Coordination Equity Quality Guarantee of right Access guarantee Variety of services
8	Networks are the instrument that guarantee the right to health, expanding access and reducing inequalities.²²22 Kuschnir R, Chorny AH. Redes de atenção à saúde: contextualizando o debate. Cien Saude Colet. 2010;15(5):2307-16. http://dx.doi.org/10.1590/S1413-81232010000500006. http://dx.doi.org/10.1590/S1413-81232010...	Brazil	Equity Access expansion Guarantee of right
9	A health service network or a health care network is the form of organization of actions and services of health promotion, prevention and recovery, in all levels of complexity, of a given territory, that enable the articulation and interconnection of the knowledge, technologies, professionals and organizations existing there, so that the citizen can access them according to his/her health needs, in a rational, harmonic, systemic and regulated way, in accordance with a technical-sanitation logic.²³23 Santos L, Andrade LOM. Interfederal health networks: a challenge to SUS in its twentieth year. Cien Saude Colet. 2011;16(3):1671-80. http://dx.doi.org/10.1590/S1413-81232011000300002. http://dx.doi.org/10.1590/S1413-81232011...	Brazil	Articulation Integrality Defined territory Intersectorality Equity Regulation Rationality
10	The Health Network is an organizational and managerial modality adopted by connected members and its dominant characteristics are adaptability, flexibility, openness, horizontality, fluidity. The concepts that govern a networked system are: common language, established rules, relevant information, coordination and quality. Therefore, it is defined as a set of organizations connected in the health-disease process that interact in a coordinated way within a designated territory, by means of institutional or contractual relationships. The generated relationship is horizontal, peer-based and delimited by the normative agreements that are established between them, outside the bureaucratic regulations of the respective institutions to which they belong or can belong.²⁴24 Chile. Ministerio de Salud. Subsecretaría de Redes Asistenciales. División de Gestión de Redes Asistenciales. Departamento de Gestión de Garantías Explícitas en Salud. Redes de atención ges y no ges [Internet]. Santiago: Ministerio de Salud; 2013. 122 p. Disponível em: http://hospitalclinicomagallanes.cl/documentos/ges/REDES-2013.pdf http://hospitalclinicomagallanes.cl/docu...	Chile	Adaptability Flexibility Openness Fluidity Horizontality Defined territory Cooperation Intersectorality Coordination Quality Formalization by contract

[1] Corresponding author:Janise Braga Barros Ferreira E-mail: janise@fmrp.usp.br

Brasil

Brasil

Concept of health care network and its key characteristics: a scoping review

Abstract

Objective

Method

Results

Conclusion and implications for practice