Methodological system for the evaluation of health networks

2019 edition

Carolina Leyton Pavez

In the last four decades there has been a growing interest in the study of production systems as a whole, over organizations as individual units, especially the analyzes on organizational networks and the configurations they present. From this perspective, the present work focused on the analysis of patient referrals among health facilities and their impact on the development of health network management in the ├Ĺuble Region (Chile).

 

The analysis of organizational networks is a research methodology that has been gaining great importance among the academic and scientific community, among others, for the possibility of understanding multiple processes of organizational structures. This offers great potential as a management tool, since it allows us to understand relational links and explain, among other things, how they interpret the changes experienced by their environment.

 

To achieve the proposed objective, we worked on three fundamental parts. The foundation analysis of organizational networks, which consisted in making an exploration of the main concepts, antecedents and potentialities of the analysis of organizational networks. In addition to the review of the case studies that contextualize the methodology of the analysis, where the metrics were identified to measure the dynamics of the network, with emphasis on local and regional environment and finally the application was made to obtain relevant conclusions of this type of analysis.

 

The concept of networks, both from its analytical and theoretical conception, is very useful to study the linkage and behavior patterns of a set of actors in a specific context, thus identifying the networks that make up and in which structure these relationships, presents an interesting horizon of relevant scientific research to understand the functioning of social systems.

 

The analysis of networks allows us to approach the phenomenon in relation to its conformation as a social network that constrains the actors involved, generating linkages and differentiated functional positions, and, at the same time, allows us to infer how the networks operate in an organized way to insert themselves in a network more dynamic, linked, for example, in the allocation of some resources or the implementation of some local-based health policies.

 

The relational dimension of society is becoming more evident every day, understanding the impact that relationships have on the trajectory of life, from everyday relationships to large capital transactions that enrich and impoverish peoples, through the links of The association of interests that conglomerate the political power of each political community is key if one looks for novel theoretical and methodological models that allow understanding the world. Network analysis, with its strengths and weaknesses, is a good start to begin to investigate the linking processes that structure society and condition the increasingly common destination.

 

On the other hand, the analysis of organizational networks introduces the relational approach lacking conventional methods of organizational analysis. Although the social sciences incorporate a concern for relationships as a fundamental explanatory element of social processes, the methods most commonly used by these researchers are quantitative methods based on conventional statistical analysis and the formalities of individualism, which fail to comprehensively address the relationships that occur in a network, to identify the importance of the position of the actors in a particular network structure as a complementary or explanatory functional element of the same. In this sense, network analysis is a useful methodological theoretical resource to address problems posed in relational terms.

 

The analysis conducted in the present study studied the health network of the ├Ĺuble Region of Chile, taking into account the referral of patients within the health network establishments, considering both the nature and characteristics of the referrals. Based on structural variables, the analysis quantifies the system of relationships and generates matrices that contain information regarding the presence of relationships between a finite set of actors (establishments of the health network) and, based on those matrices, representative graphs were constructed of the networks under study. The representation of relationships in graphs allows us to visualize, in a simple and intuitively suggestive way, the patterns of relationships and the differential positions that the actors occupy in them.

 

Quantifying the interactions of a group of actors is not enough to establish an in-depth analysis of each actor within a network. In this way, in the present study some of the main mathematical instruments are presented to generate matrices, graphs and indicators capable of explaining the structure of a network. For which it has also required computer, analytical and graphic tools to establish the interpretative potential on health networks and their subgroups, their actors and their interactions

 

Throughout the study, the usefulness of network theory and network analysis has been demonstrated to account for relational phenomena within the health context, appealing to networks and their resources as substantial support elements, analyzing the dynamics of the highly complex interaction as is the sanitary.

 

In addition, it has been shown that the study of networks is a significant contribution to understanding the dynamics of the development of local health networks, as it increases the possibility of analysis based on relationships with the group’s stakeholders and amplifies the margin of understanding of interests, affinities, competencies and attractions of the actors evaluated, by focusing on the revision of the relationships. This analysis of the networks also strengthens the understanding of the influences and their modifications resulting from the effect of various variables such as geographical mobility or changes experienced over time.

 

All these elements are conditions to take into account to be able to propose strategies aimed at improving the living conditions of these localities. While it is true that a network can be built from spontaneous relationships and through random practices, it is also true that adequate coordination of exchange policies and the enhancement of interaction resources facilitate both well-being and satisfaction with levels. It is important the development of network interventions where processes of organization of exchange practices are executed, so that the networks constituted by these populations point to the articulation of the patterns of coexistence with common needs and interest, increasing the probability of generate more open, flexible and willing contacts by integrating into the macro-sphere spheres through the creation of formal interregional or national secondary networks.

 

In this task, the State and public institutions, mainly health, are elements called to generate that articulation required for the proper functioning of health networks by setting common objectives where all the resources of the networks are used, in pro to achieve adaptation to the environment and raise the level of social capital. However, waiting for obvious findings is a process that requires study, time and persistence.

 

Finally, it is appropriate to indicate that the network intervention allows the construction of common codes that facilitate the construction of an identity, is established through a methodology for action and facilitates the production of reflective alternatives that allow thinking about the social as a whole.

 

With the new governance and budget reduction, has pushed various organizations the State to use new strategies to obtain resources, one of these strategies are the links of collaboration, which seek the participation of various bodies to support and meet their objectives, that is, to have a greater exchange of information, economic resources and to relate with key actors that could contribute to the good performance of this organization. With all this, what are being formed are organizational networks internally and externally. Networks as new organizational strategies.

 

For all of the above, in spite of being a methodology barely used in organizational practice, and unprecedented in the health field, it offers great potential as a management tool, since it allows us to understand the relational links that exist between the members of an organization and that explain, among other things, how the actors interpret the changes that the organization and its surroundings experience every day. Some interpretations that condition the behavior of organizations and that acquire special relevance in an environment such as the current one, volatile, uncertain and ambiguous, where change has become a constant. It is estimated that if managers included this methodology among their management tools, they could better focus their interventions aimed at influencing the behavior of the members of the organization, which would be more effective.

 

Finally, this experience allowed us to initiate a formal approach to the analysis of health networks and their structure; and in order to be included as management tools, to better focus interventions aimed at influencing the behavior of the members of the organization that make up the network, thereby making them more effective.