Disease-management partnership functioning, synergy and effectiveness in delivering chronic-illness care.
OBJECTIVE
This study explored associations among disease-management partnership functioning, synergy and effectiveness in the delivery of chronic-illness care.


METHODS
This study had a cross-sectional design.


METHODS
The study sample consists of 218 professionals (out of 393) participating in 22 disease-management partnerships in various regions of the Netherlands.


METHODS
We assessed the relationships among partnership functioning, synergy and effectiveness in the delivery of chronic-illness care. Partnership functioning was assessed through leadership, resources, administration and efficiency. Synergy was considered the proximal outcome of partnership functioning, which, in turn, influenced the effectiveness of disease-management partnerships [measured with the Assessment of Chronic Illness Care (ACIC) survey instrument].


RESULTS
Overall ACIC scores ranged from 3 to 10, indicating basic/intermediate to optimal/comprehensive delivery of chronic-illness care. The results of the regression analysis demonstrate that partnership effectiveness was positively associated with leadership (β = 0.25; P≤ 0.01), and resources (β = 0.31; P≤ 0.001). No significant relationship was found between administration, efficiency and partnership effectiveness. Partnership synergy acted as a mediator for partnership functioning and was statistically significantly associated with partnership effectiveness (β = 0.25; P≤ 0.001).


CONCLUSIONS
Disease-management partnerships seemed better able to deliver higher levels of chronic-illness care when synergy is created between partners. Synergy was more likely to emerge with boundary-spanning leaders who understood and appreciated partners' different perspectives, could bridge their diverse cultures and were comfortable sharing ideas, resources and power. In addition, the acknowledgement of and ability to use members' resources are valuable in engaging partners' involvement and achieving synergy in disease-management partnerships.
Institute of Health Policy and Management (iBMG), Erasmus University, Rotterdam, The Netherlands. cramm@bmg.eur.nl
Jane Murray
JM
Cramm
Anna Petra
AP
Nieboer
D000328:Adult; D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards*; D019468:Disease Management; D005260:Female; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010317:Partnership Practice / Q000458:organization & administration / Q000592:standards*; D011795:Surveys and Questionnaires