Divergent notions of 'quality' in healthcare policy implementation: a framing perspective
| Autor: | Danielle Martin, Adalsteinn D. Brown, Husayn Marani, Noah Ivers, Karen S. Palmer, Jenna M. Evans |
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| Rok vydání: | 2021 |
| Předmět: |
Ontario
Value (ethics) Government business.industry 030503 health policy & services Health Policy Corporate governance media_common.quotation_subject Context (language use) Public relations 03 medical and health sciences 0302 clinical medicine Framing (social sciences) Business Management and Accounting (miscellaneous) Quality (business) 030212 general & internal medicine Sociology Health care reform Policy Making 0305 other medical science business Delivery of Health Care Qualitative Research Health policy media_common |
| Zdroj: | Journal of Health Organization and Management. 36:87-104 |
| ISSN: | 1477-7266 |
| Popis: | PurposeThis paper examines how “quality” was framed in the design and implementation of a policy to reform hospital funding and associated care delivery. The aims of the study were: (1) To describe how government policy-makers who designed the policy and managers and clinicians who implemented the policy framed the concept of “quality” and (2) To explore how frames of quality and the framing process may have influenced policy implementation.Design/methodology/approachThe authors conducted a secondary analysis of data from a qualitative case study involving semi-structured interviews with 45 purposefully selected key informants involved in the design and implementation of the quality-based procedures policy in Ontario, Canada. The authors used framing theory to inform coding and analysis.FindingsThe authors found that policy designers perpetuated a broader frame of quality than implementers who held more narrow frames of quality. Frame divergence was further characterized by how informants framed the relationship between clinical and financial domains of quality. Several environmental and organizational factors influenced how quality was framed by implementers.Originality/valueAs health systems around the world increasingly implement new models of governance and financing to strengthen quality of care, there is a need to consider how “quality” is framed in the context of these policies and with what effect. This is the first framing analysis of “quality” in health policy. |
| Databáze: | OpenAIRE |
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