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The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews

BACKGROUND: Policymakers in many countries promote collaboration between health care organizations and other sectors as a route to improving population health. Local collaborations have been developed for decades. Yet little is known about the impact of cross-sector collaboration on health and healt...

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Autores principales: Alderwick, Hugh, Hutchings, Andrew, Briggs, Adam, Mays, Nicholas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054696/
https://www.ncbi.nlm.nih.gov/pubmed/33874927
http://dx.doi.org/10.1186/s12889-021-10630-1
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author Alderwick, Hugh
Hutchings, Andrew
Briggs, Adam
Mays, Nicholas
author_facet Alderwick, Hugh
Hutchings, Andrew
Briggs, Adam
Mays, Nicholas
author_sort Alderwick, Hugh
collection PubMed
description BACKGROUND: Policymakers in many countries promote collaboration between health care organizations and other sectors as a route to improving population health. Local collaborations have been developed for decades. Yet little is known about the impact of cross-sector collaboration on health and health equity. METHODS: We carried out a systematic review of reviews to synthesize evidence on the health impacts of collaboration between local health care and non-health care organizations, and to understand the factors affecting how these partnerships functioned. We searched four databases and included 36 studies (reviews) in our review. We extracted data from these studies and used Nvivo 12 to help categorize the data. We assessed risk of bias in the studies using standardized tools. We used a narrative approach to synthesizing and reporting the data. RESULTS: The 36 studies we reviewed included evidence on varying forms of collaboration in diverse contexts. Some studies included data on collaborations with broad population health goals, such as preventing disease and reducing health inequalities. Others focused on collaborations with a narrower focus, such as better integration between health care and social services. Overall, there is little convincing evidence to suggest that collaboration between local health care and non-health care organizations improves health outcomes. Evidence of impact on health services is mixed. And evidence of impact on resource use and spending are limited and mixed. Despite this, many studies report on factors associated with better or worse collaboration. We grouped these into five domains: motivation and purpose, relationships and cultures, resources and capabilities, governance and leadership, and external factors. But data linking factors in these domains to collaboration outcomes is sparse. CONCLUSIONS: In theory, collaboration between local health care and non-health care organizations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers. Ultimately, local collaborations should be understood within their macro-level political and economic context, and as one component within a wider system of factors and interventions interacting to shape population health. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-10630-1.
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spelling pubmed-80546962021-04-20 The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews Alderwick, Hugh Hutchings, Andrew Briggs, Adam Mays, Nicholas BMC Public Health Research Article BACKGROUND: Policymakers in many countries promote collaboration between health care organizations and other sectors as a route to improving population health. Local collaborations have been developed for decades. Yet little is known about the impact of cross-sector collaboration on health and health equity. METHODS: We carried out a systematic review of reviews to synthesize evidence on the health impacts of collaboration between local health care and non-health care organizations, and to understand the factors affecting how these partnerships functioned. We searched four databases and included 36 studies (reviews) in our review. We extracted data from these studies and used Nvivo 12 to help categorize the data. We assessed risk of bias in the studies using standardized tools. We used a narrative approach to synthesizing and reporting the data. RESULTS: The 36 studies we reviewed included evidence on varying forms of collaboration in diverse contexts. Some studies included data on collaborations with broad population health goals, such as preventing disease and reducing health inequalities. Others focused on collaborations with a narrower focus, such as better integration between health care and social services. Overall, there is little convincing evidence to suggest that collaboration between local health care and non-health care organizations improves health outcomes. Evidence of impact on health services is mixed. And evidence of impact on resource use and spending are limited and mixed. Despite this, many studies report on factors associated with better or worse collaboration. We grouped these into five domains: motivation and purpose, relationships and cultures, resources and capabilities, governance and leadership, and external factors. But data linking factors in these domains to collaboration outcomes is sparse. CONCLUSIONS: In theory, collaboration between local health care and non-health care organizations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers. Ultimately, local collaborations should be understood within their macro-level political and economic context, and as one component within a wider system of factors and interventions interacting to shape population health. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-10630-1. BioMed Central 2021-04-19 /pmc/articles/PMC8054696/ /pubmed/33874927 http://dx.doi.org/10.1186/s12889-021-10630-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Alderwick, Hugh
Hutchings, Andrew
Briggs, Adam
Mays, Nicholas
The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews
title The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews
title_full The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews
title_fullStr The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews
title_full_unstemmed The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews
title_short The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews
title_sort impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054696/
https://www.ncbi.nlm.nih.gov/pubmed/33874927
http://dx.doi.org/10.1186/s12889-021-10630-1
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