Paper/Speech Details of Conference Program for the 31st NISPAcee Annual Conference Program Overview WG1: Local Government Author(s) Iwona Sobis University of Gothenburg Göteborg Sweden Title The alleged culprit of poor coordination of integration of health- and social care services for very ill elderly persons in Sweden, 2000-2022 File Paper files are available only for conference participants, please login first. Presenter Iwona Sobis Abstract Despite many attempts to transform the Swedish elderly care, similar problems are observed for its coordination by years. The aim of this literature review is to identify the coordination mechanisms, perceived as the alleged culprit, behind the poor coordination of integrated health- and social services for very ill older persons in Sweden, 2000 – 2022. Classical and contemporary coordination theories are used to identify those coordination mechanisms. The analysis was based on the content of the collected articles from this thematic area. From this literature review appears that following coordination mechanism are perceived as the alleged culprit, behind the poor coordination of the elderly care: (1) plan, program, rules, and standardisation of work processes. Research confirmed that decentralization, autonomy of regional and local authorities, new regulations conducted in the spirit of NPM, and the double principalship prevented the integration of care for seriously ill seniors; (2) roles, standardisation of skills, and direct supervision. Both organizational principals do nothing with excess work of employees, insufficient number of employees providing care services, which in turn generate stress, conflicts, and even occupational burnout of staff. They do not care enough about the development of staff competencies; (3) proximity, feedback, and adjustments by mutual communication. Most studies showed that communication among staff was most important to reach integration. It didn’t work among staff involved in care providing. Knowledge about 'objects and representations' and 'routines and standardization of outcomes' is rather limited and deserve research.
