MANAGED CLINICAL NETWORKS: SCOPE, EVIDENCES, AND FEASIBILITY

Federico Lega (1) , Marco Sartirana (1)

1 Institutional Analysis and Public Management

Objectives Managed Clinical Networks (MCNs) are emerging internationally as an innovative organizational model of care for complex diseases, and are expected to achieve multiple, and in some cases contrasting, health policy goals. We provide a synthesis of expected network outcomes and discuss the evidence found in the literature on cancer networks. Methods We performed a systematic search in the databases PubMed and EBSCO-Business Source Complete, together with a large portion of grey literature on cancer MCNs. Results We propose the following synthesis of expected network outcomes: increase in the quality of health care services; in the equity of access; in knowledge transfer; in the cost effectiveness of health services; in patient centeredness of services. While intangible and intermediate outcomes were often reported, there is a paucity of evidence in favor of ultimate network performances, especially in terms of quality of care, cost effectiveness of services and patients' experiences. Conclusions Our findings on cancer MCNs suggest that there are promising signs of positive returns from MCNs, yet the picture is less enthusiastic than what described in the grey literature. We discuss policy implications and recommendations for health administrators, including the necessity to identify performance indicators and to analyze further the influence of pre-existing and context-related conditions on performance.

Mots clés: Medicine

Federico Lega, Marco Sartirana. MANAGED CLINICAL NETWORKS: SCOPE, EVIDENCES, AND FEASIBILITY. International Journal of Clinical Practice, 2011, 65 (7), pp.725. ⟨10.1111/j.1742-1241.2011.02686.x⟩. ⟨hal-00652660⟩