Exploring the triggering process of a cancer care reform in three Scandinavian countries.

Autor: Maehle PM; Department of Health and Society, Faculty of Medicine, University of Oslo, Norway.; Division of Cancer Medicine, Comprehensive Cancer Centre, Oslo University Hospital, Norway., Hajdarevic S; Department of Nursing and Department of Public Health and Clinical Medicine, Family Medicine, University of Umeå, Sweden.; Department of Public Health and Clinical Medicine, Family Medicine, University of Umeå, Sweden., Håland E; Department of Education and Lifelong Learning, NTNU, Trondheim, Norway., Aarhus R; Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Denmark., Smeland S; Division of Cancer Medicine, Comprehensive Cancer Centre, Oslo University Hospital, Norway.; Department of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway., Mørk BE; Department of Strategy and Entrepreneurship, Norwegian Business School, Oslo, Norway.; Warwick Business School, University of Warwick, Coventry, UK.
Jazyk: angličtina
Zdroj: The International journal of health planning and management [Int J Health Plann Manage] 2021 Nov; Vol. 36 (6), pp. 2231-2247. Date of Electronic Publication: 2021 Jul 21.
DOI: 10.1002/hpm.3278
Abstrakt: Cancer incidence is increasing, and cancer is a leading cause of death in the Scandinavian countries, and at the same time more efficient but very expensive new treatment options are available. Based on the increasing demand, high expectations and limited resources, crises in public legitimacy of cancer care evolved in the three Scandinavian countries. Similar cancer care reforms were introduced in the period 2007-2015 to address the crisis. In this article we explore processes triggering these reforms in countries with similar and well-developed health care systems. The common objective was the need to reduce time from referral to start treatment, and the tool introduced to accomplish this was integrated care pathways for cancer diagnosis, that is Cancer Patient Pathways. This study investigates the process by drawing on interviews with key actors and public documents. We identified three main logics in play; the economic-administrative, the medical and the patient-related logic and explored how institutional entrepreneurs skillfully aligned these logics. The article contributes by describing the triggering processes on politically initiated similar reforms in the three countries studied and also contributes to a better understanding on the orchestrating of politically initiated health care reforms with the intention to change medical practice in hospitals.
(© 2021 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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