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Lost in translation: a patient‐centred experience of unintegrated care

Hannele Kerosuo (University of Helsinki, Helsinki, Finland)

International Journal of Public Sector Management

ISSN: 0951-3558

Article publication date: 1 June 2010




This paper seeks to take a patient‐centred perspective in exploring the treatment of multiple and chronic illnesses in inter‐organizational care practice in Finland.


The theoretical approach of the study is based on the sociology of translation and on cultural historical activity theory. The methodology of multi‐locale ethnography is used to research the translations in one patient's healthcare procedures in multiple care settings.


The care procedures emerge as unintegrated for the patient in the study. The patient has to take responsibility for his overall care since the medical professionals involved have only limited knowledge of other providers' care procedures. Despite their efforts to collaborate, professionals are lost in translation across healthcare boundaries.

Research limitations/implications

Single cases are problematic for advancing generalizations on a research topic. The case of this study presents an example of the translations in the care procedures for a patient with multiple and chronic illnesses.

Practical implications

Unintegrated care organization poses a difficult challenge to patient‐centred care if the ideals of consumerism are followed in the health care system. A patient, with limited medical knowledge, may not be able to master an overall pattern of chronic illness care in a sustainable way. Better management and coordination of specialized knowledge are required for patients with chronic illnesses.


In contrast with the many studies that report on patients' experiences of illness, the paper provides new insights into the patient experience of health care organization.



Kerosuo, H. (2010), "Lost in translation: a patient‐centred experience of unintegrated care", International Journal of Public Sector Management, Vol. 23 No. 4, pp. 372-380.



Emerald Group Publishing Limited

Copyright © 2010, Emerald Group Publishing Limited

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