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Cooperation between healthcare professionals and organizations in action: Neo-structural analysis applied to MSPs

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2022. Ressources en ligne : Abrégé : To what extent do Maisons de santé pluriprofessionnelles (MSPs) (Multidisciplinary Group Practices) promote inter-individual and inter-organizational cooperation within their territory? As these structures have grown exponentially over the past ten years (from 174 in 2012 to more than 1,200 in 2019 according to the Fédération française des maisons et pôles de santé [French Federation of Multidisciplinary Group Practices]), they offer a relevant area of observation to assess the effects of public policies dealing with the dynamics of cooperation between health professionals, which have become central to the territorial organization of care over the past fifteen years. Using a multi-level structural analysis (Lazega, Jourda, Mounier, and Stofer 2007), we highlight the cooperation processes involving MSPs in a French département, at both the inter-individual level and the inter-organizational level. We also analyze the interactions between these two levels. The cross-study of these two systems of interdependence (Lazega 2015; Lazega and Snijders 2016) allows us to understand the cooperation “in action” in MSPs. The statistical analysis of the networks shows that these structures seem to enhance multidisciplinary interaction and to play a structuring role in the sharing of patient files between organizations. However, the multi-level analysis does not show that health professionals interact preferentially with MSP professionals: the individual characteristics (gender, age, place of practice) of professionals and their position in the organization prevail in the construction of professional interaction. The non-alignment of the links between organizations with the links between individuals therefore challenges the coherence of public policies promoting group practices, which relate both to professionals as individual actors and to healthcare organizations as a framework for collective action.
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To what extent do Maisons de santé pluriprofessionnelles (MSPs) (Multidisciplinary Group Practices) promote inter-individual and inter-organizational cooperation within their territory? As these structures have grown exponentially over the past ten years (from 174 in 2012 to more than 1,200 in 2019 according to the Fédération française des maisons et pôles de santé [French Federation of Multidisciplinary Group Practices]), they offer a relevant area of observation to assess the effects of public policies dealing with the dynamics of cooperation between health professionals, which have become central to the territorial organization of care over the past fifteen years. Using a multi-level structural analysis (Lazega, Jourda, Mounier, and Stofer 2007), we highlight the cooperation processes involving MSPs in a French département, at both the inter-individual level and the inter-organizational level. We also analyze the interactions between these two levels. The cross-study of these two systems of interdependence (Lazega 2015; Lazega and Snijders 2016) allows us to understand the cooperation “in action” in MSPs. The statistical analysis of the networks shows that these structures seem to enhance multidisciplinary interaction and to play a structuring role in the sharing of patient files between organizations. However, the multi-level analysis does not show that health professionals interact preferentially with MSP professionals: the individual characteristics (gender, age, place of practice) of professionals and their position in the organization prevail in the construction of professional interaction. The non-alignment of the links between organizations with the links between individuals therefore challenges the coherence of public policies promoting group practices, which relate both to professionals as individual actors and to healthcare organizations as a framework for collective action.

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