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Associations between structures, processes and outcomes in inter-municipal cooperation in out-of-hours services in Norway: A survey study

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  • Arntsen, Bjørnulf
  • Torjesen, Dag Olaf
  • Karlsen, Tor-Ivar

Abstract

Inter-municipal cooperation (IMC) has gained widespread recognition as a beneficial strategy for improving efficiency and quality in the provision of out-of-hours emergency care services (OOH services). Little attention, however, has been given to the additional costs of cooperation and the relational processes through which benefits and costs are likely to result. Based on survey data from 266 (77%) Norwegian municipalities involved in IMC in OOH services in 2015, this study aimed to investigate how the structure (governance form, complexity and stability) and quality (trust and consensus) of cooperation processes interact to influence the perceived outcomes (benefits and costs) of IMC in OOH services. Using Structural equation modeling, we found trust and consensus fully mediated the association between the structure and outcomes of IMC. More specifically, the results suggest that cooperation structures characterized by centralized governance, stability over time, and reduced complexity were likely to enhance the benefits and reduce the costs of IMC through trust and consensus.

Suggested Citation

  • Arntsen, Bjørnulf & Torjesen, Dag Olaf & Karlsen, Tor-Ivar, 2020. "Associations between structures, processes and outcomes in inter-municipal cooperation in out-of-hours services in Norway: A survey study," Social Science & Medicine, Elsevier, vol. 258(C).
    • Handle: RePEc:eee:socmed:v:258:y:2020:i:c:s0277953620302860
    DOI: 10.1016/j.socscimed.2020.113067
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    1. Arntsen, Bjørnulf & Torjesen, Dag Olaf & Karlsen, Tor-Ivar, 2021. "Asymmetry in inter-municipal cooperation in health services – How does it affect service quality and autonomy?," Social Science & Medicine, Elsevier, vol. 273(C).
    2. Katarzyna Sienkiewicz-Małyjurek & Tomasz Owczarek, 2020. "Complementarity of Communication and Coordination in Ensuring Effectiveness of Emergency Management Networks," Sustainability, MDPI, vol. 13(1), pages 1-20, December.

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