L'imperativo della collaborazione: la prospettiva inter-organizzativa per una nuova lettura dell'integrazione socio-sanitaria

This PhD thesis introduces a review of the international literature in the field of inter-organizational relationships, with the purpose of devising a robust theoretical framework intended at fostering the conceptual and empirical research about the dynamics of cooperation and collaboration that concern public sector organizations. Although the proposed theoretical framework has a wide applicability, the Author focuses on the integration of health and social care, conceiving it as a complex process of recovery from the current situation of institutional, organizational, professional, and cultural detachment that divide health and social care providers. Drawing from the evolution of managerial models in the public sector, the Author argues for the transition toward a systemic approach in the management of health and social care, which is evocatively defined as “New Health Governance”. It emphasizes the importance of interorganizational relationships to enhance the capability of both health and social care organizations to pursue their institutional aims. Despite the latter have been usually understood as parts of a weakly coupled system, they have been infrequently aware of their mutual interdependencies and, as a consequence, they have not adequately exploited their underlying synergies. Such a circumstance undermines the health and social care organizations’ ability to meet the growing and complex needs of their served population, with serious backlashes on their long-term sustainability. From this standpoint, inter-organizational relationships are acknowledged as a critical success factor for both health and social care organizations. Assuming the fragmentation of the scholarly literature in this field, an in-depth double layered literature review has been realized, with the purpose of providing a synthesis of the main theoretical and empirical argumentations claimed by the scholars who have discussed about this topic. On the one hand, the attention has been paid to interorganizational relationships in general terms, collecting and analysing scientific contributions dealing with: the determinants of collaborative and/or cooperative relationships between two or more organizations, the process of implementation of inter-organizational relationships, the prevailing models of governance of the latter, the costs and the benefits associated with them, and the management of the underlying organizational interdependencies. The formulae: “inter-organizational relation”, “inter-organizational relationship”, “interorganizational relation”, and “interorganizational relationship” have been employed as criteria of the research within the field “keywords, title and abstract” of the database “ScopusElsevier”. No temporal limitations or exclusion criteria relying on the type of publication were assumed. On the whole, 1.333 scientific contributions were collected; they have been arranged in electronic worksheets and systematized in order to remove redundancies, that is to say contributions retrieved more than one time due to their conformity with two or more criteria of research. Consistently, 603 items were deleted; the remaining 730 contributions underwent an in-depth content analysis of their abstract. Complying with specific criteria of selection aimed at skimming off the items that were not consistent with the aims of the research, 157 contributions were included in the study. Three out of four selected contributions were represented by articles in refereed journals; the remaining part mainly consisted of proceedings and, secondly, by chapters in edited books and monographs. .. [edited by Author]