Table 1
Municipal health centre configuration.
| Local Government Sector | Regional Government Sector | Private practicing sector |
|---|---|---|
| Physiotherapy | 4 GPs + staff | Paediatric psychologist |
| Home care | Midwife | Chiropodist |
| Home nursing | Chiropractor | |
| Physical rehabilitation | Paediatric occupational | |
| Health clinic (disease prevention + health promotion) | therapy Health coach Reflexive therapy |
Table 2
Respondents
| Sectors | Administrators (interview) | Health professionals (interview) |
|---|---|---|
| Regional Government | Head of Division (a) Head of Section (b) | GP1 (j), GP2 (k) GP3 (l), GP4 (m) |
| Local Government | CEO of Department of Social Services and Labour Market (c Executive officer from Administration of Social Services and Labour Market (d) Head of Division of Labour Market (e) Head of Division of Active Nursing and Care (f) Head of Division of Health and Rehabilitation (g) Head of Nursing (h) Head of Rehabilitation (i) | Physiotherapist 1 (n) Physiotherapist 2 (o) Nurse 1 (p) Nurse 2 (q) |
| Private sector | N.a. | Psychologist (r) Chiropodist (s) Chiropractor (t) |
Table 3
Key themes from the interview guides.
| Respondents | |
|---|---|
| All | Respondent’s background and role concerning the health centre; perceptions of communication between actors in the establishment phase/operation phase; respondents’ function in and expectations of the health centre; benefits for citizens/patients, understanding of the implications of ‘co-location’; suggestions of forms of cross-sectoral collaborations; expectations of/experiences with GPs as coordinators within health centre; relationship between administrators and health professionals |
| Local and regional administrators | Motivation for establishing centre; strategic/everyday management of health centre; strategic agreements’ impact on cross-sectoral collaboration; configuration of health centre; initiatives taken to increase cross-sectoral collaboration with GPs as coordinators and possible examples hereof |
| Health professionals within the health centre | Motivation for moving into health centre; description of a normal workday; types of patients; benefits of co-location experienced personally/disadvantages of being located within the health centre; relationships between health professionals; possible patient benefits from cross-sectoral collaborations; barriers/drivers |
Table 4
Global theme: Co-location as driver for cross-sectoral collaboration.
| Thematic network analysis [54] | ||
|---|---|---|
| Basic themes: Factors influencing co-location as a driver for cross-sectoral collaboration with GPs as coordinators (interviews containing the code cf. Table 2) | Organizing themes: Dimensions | Global theme |
| Co-location facilitates – non-planned cross-sectoral communication (b, c, f, i, j, k, l, m, o, p, r) | Personal relations, trust and communication as drivers | Co-location as driver for cross-sectoral collaboration with GPs as coordinators in health centre |
| Increased communication – raise awareness of the identity of other actors thereby developing relationships (a, h, i, j, m, p, q) | ||
| GPs’ work schedules and treatment approaches impede cross-sectoral collaboration generated by co-location (a, g, j, k, l, n, o, p, q) | GPs’ work routines and professional identity as barriers | |
| GPs perceive that they work in a ‘Doctors Clinic’ instead of a ‘Health Centre’ (a, j, k, l, m, t) | ||
| GPs not interested in social activities or general meetings with co-located health professionals (b, j, k, m, r, s, t) | ||
| GPs’ collective agreement undermines implementation of strategic agreements (‘Health Agreement’ and ‘Plan for GP’) that commits GPs to be cross-sectoral coordinators in health centre (a, b, j, k, l, m) | Unaligned economic incentives as a barrier | |
| GPs activity-based remuneration and municipal health professionals’ monthly salaries impede cross-sectoral collaboration (a, b, c, f, g, j, k, l, m, r) | ||
| Lack of evidence/suggestions concerning cross-sectoral collaboration with GPs as coordinators (a, c, e, h, i, j, l, r) | Lack of clarity concerning the content of collaboration as a barrier | |
| Lack of clarity concerning the location of responsibility for developing content of cross-sectoral collaboration (a, b, c, j, k, m, n, o, t) | ||
| Health centre effectively functions as rental co-op (no admission criteria for private health professionals other than willingness to pay rent) (b, c, f, g, r, t) | Organisational issues as barriers | |
| Cross-sectoral collaboration driven by co-location primarily included in initial project description in order to obtain national funding (d, l) | ||
| Both local and regional government administrative levels and health professionals within the health centre are passive and fail explicitly to request cross-sectoral collaborations involving GPs (a, c, e, f, g, h, i, j, l, m, n, p, r, s, t) | ||
| Lack of common vision/goals/organisation concerning cross-sectoral collaboration with GPs as coordinators in the health centre (a, b, c, f, g, l, n, r, t) |