Open Access Research article

Do governance choices matter in health care networks?: an exploratory configuration study of health care networks

Annick Willem1* and Paul Gemmel2

Author Affiliations

1 Faculty of Medicine and Health Sciences, Department of Movement and Sport Sciences, Ghent University, Watersportlaan 2, Ghent 9000, Belgium

2 Faculty of Economics and Business Administration, Ghent University, Tweekerkenstraat 2, Ghent 9000, Belgium

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BMC Health Services Research 2013, 13:229  doi:10.1186/1472-6963-13-229

Published: 24 June 2013



Health care networks are widely used and accepted as an organizational form that enables integrated care as well as dealing with complex matters in health care. However, research on the governance of health care networks lags behind. The research aim of our study is to explore the type and importance of governance structure and governance mechanisms for network effectiveness.


The study has a multiple case study design and covers 22 health care networks. Using a configuration view, combinations of network governance and other network characteristics were studied on the level of the network. Based on interview and questionnaire data, network characteristics were identified and patterns in the data looked for.


Neither a dominant (or optimal) governance structure or mechanism nor a perfect fit among governance and other characteristics were revealed, but a number of characteristics that need further study might be related to effective networks such as the role of governmental agencies, legitimacy, and relational, hierarchical, and contractual governance mechanisms as complementary factors.


Although the results emphasize the situational character of network governance and effectiveness, they give practitioners in the health care sector indications of which factors might be more or less crucial for network effectiveness.

Governance; Health care; Networks; Organization theory