Out-of-Network Factors Affecting Governance in the Health System: Systematic Review

Networked collaborations have become a critical approach to enhance providing quality service in health care systems. The use of collaboration structures and coordination mechanisms as a desirable governance model is essential for the success of network collaboration. There are different factors influencing designing good network governance models in health care networks. Considering the importance of these factors in designing the governance model, the comprehensive review of factors out of the network control has not yet been addressed. The aim of this paper is to identify the factors that are out of network control and influencing designing a good network governance model in health care systems.We apply a systematic literature review (SLR) to identify the intended factors. During searching for studies associated with our research question in the WEB OF SCIENCE database as a comprehensive database, the 1500 publications resulted. Screening resulted publications basis of title fitness with inclusion and conclusion criteria led to the 150 articles. Final screening the 150 articles basis of abstract and conclusion led to the 11 final articles that the 15 pieces of evidence were extracted from them. After synthesizing the extracted evidences for achieving an integrated view of them led to the 4 classes with the 15 components. In this regard, the environmental requirements, the level of government intervention in the health system, the nature of policies and interventions in the health system, as well as the rates of referrals in health networks were identified as the most important factors outside the network control. Network governance will succeed if the influencing factors are taken into account in designing it.