Email updates

Keep up to date with the latest news and content from BMC Health Services Research and BioMed Central.

Open Access Research article

Partnership disengagement from primary community care networks (PCCNs): A qualitative study for a national demonstration project

Chia-Yi Liau1, Cheng-Chieh Lin2345, Yung-Kai Lin6 and Blossom Yen-Ju Lin2*

Author Affiliations

1 Taichung Hospital, Department of Health, Executive Yuan, Taichung, Taiwan

2 School and Graduate Institute of Health Services Administration, College of Public Health, China Medical University, Taichung, Taiwan

3 Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan

4 College of Medicine, China Medical University, Taichung, Taiwan

5 Institute of Health Care Administration, College of Health Science, Asia University, Taichung, Taiwan

6 Division of Cardiovascular Surgery, Taichung Veterans General Hospital, Taichung, Taiwan

For all author emails, please log on.

BMC Health Services Research 2010, 10:87  doi:10.1186/1472-6963-10-87

Published: 2 April 2010

Abstract

Background

The Primary Community Care Network (PCCN) Demonstration Project, launched by the Bureau of National Health Insurance (BNHI) in 2003, is still in progress. Partnership structures in PCCNs represent both contractual clinic-to-clinic and clinic-to-hospital member relationships of organizational aspects. The partnership structures are the formal relationships between individuals and the total network. Their organizational design aims to ensure effective communication, coordination, and integration across the total network. Previous studies have focused largely on how contractual integration among the partnerships works and on its effects. Few studies, however, have tried to understand partnership disengagement in PCCNs. This study explores why some partnerships in PCCNs disengage.

Methods

This study used a qualitative methodology with semi-structured questions for in-depth interviews. The semi-structured questions were pre-designed to explore the factors driving partnership disengagement. Thirty-seven clinic members who had withdrawn from their PCCNs were identified from the 2003-2005 Taiwan Primary Community Care Network Lists.

Results

Organization/participant factors (extra working time spend and facility competency), network factors (partner collaboration), and community factors (health policy design incompatibility, patient-physician relationship, and effectiveness) are reasons for clinic physicians to withdraw or change their partnerships within the PCCNs.

Conclusions

To strengthen partnership relationships, several suggestions are made, including to establish clinic and hospital member relationships, and to reduce administrative work. In addition, both educating the public about the concept of family doctors and ensuring well-organized national health policies could help health care providers improve the integration processes.