Figure 1
Sampling scheme across levels.
Table 1
Descriptive Statistics.
| Variable | Obs | Mean | Std. Dev. | Min | Max |
|---|---|---|---|---|---|
| Level 1 Individual level variables | |||||
| Integrated care | |||||
| Provider knowledge of patient | 2427 | 3.16 | 0.65 | 1 | 4 |
| Staff knowledge of patient’s medical history | 1795 | 2.98 | 0.79 | 1 | 4 |
| Specialist knowledge of patient’s medical history | 1397 | 2.52 | 0.75 | 1 | 4 |
| Support for self-directed care | 2887 | 2.23 | 1.01 | 1 | 4 |
| Support for medication and home health management | 2854 | 2.17 | 0.89 | 1 | 4 |
| Test result communication | 2127 | 2.96 | 0.89 | 1 | 4 |
| Self-reported health | |||||
| Poor | 2911 | 3.85% | – | 0 | 1 |
| Fair | 2911 | 30.30% | – | 0 | 1 |
| Good | 2911 | 54.69% | – | 0 | 1 |
| Very good | 2911 | 9.41% | – | 0 | 1 |
| Excellent | 2911 | 1.75% | – | 0 | 1 |
| Age | |||||
| 34 or less | 2911 | 0.34% | – | 0 | 1 |
| 35–44 | 2911 | 1.51% | – | 0 | 1 |
| 45–54 | 2911 | 9.58% | – | 0 | 1 |
| 55–64 | 2911 | 25.15% | – | 0 | 1 |
| 65–74 | 2911 | 35.69% | – | 0 | 1 |
| 75 or older | 2911 | 26.59% | – | 0 | 1 |
| Level of education | |||||
| Low | 2911 | 21.92% | – | 0 | 1 |
| Middle 11 | 2911 | 34.01% | – | 0 | 1 |
| Middle 22 | 2911 | 18.17% | – | 0 | 1 |
| High3 | 2911 | 14.05% | – | 0 | 1 |
| Other | 2911 | 9.03% | – | 0 | 1 |
| Origin | |||||
| Dutch | 2911 | 95.36% | – | 0 | 1 |
| Non–Dutch | 2911 | 4.63% | – | 0 | 1 |
| Gender | |||||
| Male | 2911 | 46.96% | – | 0 | 1 |
| Female | 2911 | 53.04% | – | 0 | 1 |
| Had help completing the survey | 2911 | 16.87% | – | 0 | 1 |
| Had no help completing the survey | 2911 | 83.13% | – | 0 | 1 |
| Level 2 Team level | |||||
| Clan culture | 1749 | 38.24 | 5.06 | 29.38 | 47.08 |
| Adhocracy culture | 1749 | 29.24 | 4.36 | 20.42 | 36.12 |
| Hierarchy culture | 1749 | 23.27 | 3.03 | 21.46 | 32.24 |
| Market culture | 1749 | 9.25 | 3.76 | 4.17 | 16.56 |
| Team tenure | 1775 | 13.47 | 9.19 | 3.0 | 26.5 |
| Team FTE | 1775 | 0.69 | 0.27 | 0.16 | 0.93 |
| N of team members | 2778 | 2.67 | 0.81 | 2.00 | 5.00 |
| Level 3 Organisational level | |||||
| N of registered patients | 2911 | 6007.00 | 1063.86 | 4534 | 6917 |
| Age | 2911 | 7.46 | 3.80 | 3 | 12 |
| N of employees | 2911 | 46.71 | 9.56 | 39 | 65 |
[i] 1 General secondary education, primary vocational education.
2 General secondary education, pre-university education, secondary vocational education.
3 Higher degree of education and university.
Table 2
HLM Models: Summary of the Association between Culture Types and Dimensions of Integrated Care.
| Provider knowledge of patient | Staff knowledge of patient’s medical history | Specialist knowledge of patient’s medical history | Support for self-directed care | Support for medication and home health management | Test result communication | |
|---|---|---|---|---|---|---|
| Odds ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | Odds ratio (95% CI) | |
| Clan | 1.06 (0.99–1.13) | 1.07** (1.03–1.12) | 0.98 (0.82–1.17) | 1.09* (1.02–1.18) | 1.12** (1.09–1.15) | 1.04 (0.96–1.13) |
| Squared term | 1.00 (0.99–1.01) | 0.98** (0.98–0.99) | 0.99 (0.96–1.02) | 1.00 (0.98–1.02) | 0.98** (0.97–0.99) | 0.99 (0.97–1.00) |
| Adhocracy | 0.99 (0.98–1.00) | 1.06** (1.05–1.08) | 1.02 (0.97–1.08) | 1.01 (0.98–1.03) | 1.09** (1.07–1.11) | 1.00 (1.00–1.01) |
| Squared term | 1.00 (0.99–1.00) | 1.00 (0.99–1.02) | 1.01* (1.00–1.02) | 0.98* (0.97–1.00) | 1.02** (1.01–1.03) | 1.01 (1.00–1.02) |
| Hierarchy | 1.06 (0.94–1.19) | 1.14 (0.95–1.35) | 1.07 (0.89–1.29) | 1.08 (0.86–1.36) | 1.10 (0.84–1.43) | 1.17** (1.07–1.28) |
| Squared term | 0.99 (0.96–1.02) | 0.96* (0.92–1.00) | 0.98 (0.96–1.01) | 0.98 (0.94–1.03) | 0.96 (0.91–1.02) | 0.96** (0.94–0.98) |
| Market | 0.98 (0.87–1.12) | 0.95 (0.87–1.03) | 0.97 (0.74–1.27) | 0.95 (0.81–1.10) | 0.87** (0.79–0.95) | 1.04 (0.97–1.12) |
| Squared term | 0.99 (0.96–1.02) | 0.98 (0.97–1.00) | 1.00 (0.94–1.06) | 0.99 (0.96–1.03) | 1.00 (0.98–1.02) | 0.97** (0.96–0.99) |
[i] * p < .05. ** p < .01.
Notes:
(1) Table summarizes 24 multilevel models. The results of the full models are provided in the technical appendix.
(2) The effects shown are controlled for patient-level covariates (general health rating, age, level of education, origin), team-level covariates (average team tenure, average team FTE, number of members in the team) and centre-level covariates (number of registered patients, organisational maturity (age in years), number of employees).
Figure 2
Associations between team culture and dimensions of integrated care. A flat line suggests no association between the culture type and dimensions of care integration. An inclining linear line suggests a positive relationship. A declining linear line suggests a negative relationship. A curvilinear line suggests that the relationship is non-linear. If the curve is concave, it suggests that moderate levels of a culture type correlate with highest patient ratings for integrated care. A convex shape suggests that high and low levels of a culture type achieve most optimal ratings.
* p < 0.05.
** p < 0.01.