Exploring coordination mechanisms in multimorbid health care: a semi-systematic literature review

Purpose This study aims to explore the challenges of coordinating multimorbid healthcare – provision of care for patients with two or more chronic conditions. The traditional operating logic of hospitals is based on single-disease pathways and guidelines, which are not well suited to addressing more complex pathways that involve combinations of services being provided to an individual patient. Design/methodology/approach We conducted a semi-systematic literature review to examine how coordination occurs between independent hospitals’ departments, units or clinics. Drawing from research in healthcare management and operations management within healthcare research fields. We applied a conceptual framework of coordination mechanisms as the instrument for the literature analysis. Findings Our findings show that coordination in multimorbid settings requires the operationalization of more mechanisms simultaneously, which are different from those applied to less complex settings. They highlight the importance of mechanisms that support the development of flexibility capabilities to ensure operational continuity and adapt to fluctuating demand and dynamic interfaces between professional and organizational levels. The study emphasizes the role of multimorbid patients as coordinators, the development of additional patients’ self-management skills, and changes in the roles of healthcare professionals as educators or facilitators. Originality/value The study enhances the understanding of how certain coordination mechanisms have adapted to shift from single- to multispecialty focused healthcare, despite the healthcare system’s continued reliance on care delivery segmented into specialized silos. Our study also suggests that there is an observable transition in research from intra to interorganizational coordination across the network of healthcare professionals and organizations.