What Drives the Centralization or Decentralization of Network Governance? A Configurational Analysis in Different Health and Social Care Networks

Many studies have sought to identify the contingency factors of success in various network governance mechanisms. Despite the relevance of their results, the contingency factors that determine the establishment of specific governance forms remain unclear. Through a qualitative comparative analysis of 13 networks of health and social care integration in Milan (Italy), we explore how diverse configurations of contingency factors produce different governance forms. The results highlight three models. The first clarifies the pathways for centralized governance; the second focuses on those resulting in decentralized governance, and the third demonstrates the existence of hybrid pathways that can lead to hybrid outcomes, underlining the importance of including other contingency factors and assessing them periodically over time. These results yield theoretical and practical insights into how various factors may collectively influence the establishment of centralized/decentralized governance.