Effectiveness of Healthcare Networks: An Empirical Study of Determinants and Their Effects on Outcomes

In a context increasingly marked by economic constraints and a sharp increase in demand, healthcare organisations have chosen to abandon the individualistic logic of service delivery and move towards a collaborative approach. Drivers of the change are population aging and the prevalence of chronic conditions, demanding long-term, integrated responses. This new mode of provision necessitates a fresh perspective on collective performance analysis, with a particular focus on the effectiveness of care – an aspect less commonly investigated due to measurement challenges and variations in meaning across areas. Adopting a tripartite meaning of effectiveness (clinical, internal and external), the research aims to investigate whether a connection exists between specific network determinants and the effectiveness of care provision. The study seeks to bridge this gap by exploring how Italian regions, subject to national legislation and characterised by substantial heterogeneity among regional systems, supervise their networks in relation to the structure, context, and process within the domain of stroke. A multiple-case study is carried out on five time-dependent networks, with a focus on stroke, characterised by high performance. The combination of data sourced from norms, strategic-operational documents, and interviews, along with patterns observed across cases, led to the formulation of five theoretical propositions synthesised into a preliminary model of network effectiveness. This research contributes to advance the understanding of what conditions may enhance a network's outcomes in terms of effectiveness, it offers insights into stage-specific determinants and outcomes related to different types of effectiveness. The study further identifies a path for implementing the diverse types of effectiveness based on the level of network development, provides a path for network formalisation and potential deviations from it, as well as insights on the role and intensity of trust.