Search results

The paper aims to account for the substance of non‐linear governance change by analysing the importance of sector‐specific institutions and the pathways of governing they create.

The analysis uses recent reforms of the governance of medical performance in four European countries as a case, adopting an inductively oriented approach to comparison. The governance of medical performance is a good case as it is both, closely related to redistributive policies, where the influence of institutions tends to be pertinent, and is subject to considerable policy pressures.

The overall thrust of reforms is similar across countries, while there are important differences in relation to how individual forms of governance and the balance between different forms of governance are changing. More specifically, sector‐specific institutions can account for the specific ways in which reforms redefine hierarchy and professional self‐regulation and for the extent to which reforms strengthen hierarchy and affect the balance with other forms of governance.

The recent literature on governance mainly focuses on mapping out the substance of non‐linear change, whereas the development of explanations of the substance of governance change is less systematic. In the present paper, therefore, it is suggested coupling the notion of non‐linear change with an analysis of sector specific institutions inspired by the historical institutionalist tradition to better account for the substance of non‐linear governance change. Further, the analysis offers interesting insights into the complexity of redrawing boundaries between the public and the private in health care.

The purpose of this paper is to investigate different types of patient involvement in Denmark, and to discuss the potential implications of pursuing several strategies for patient involvement simultaneously.

The paper presents a preliminary framework for analysis of patient involvement in health care. This framework is used to analyze key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care.

Patient involvement is important in Denmark at the rhetorical level, and many policies and initiatives have been introduced. All three governance forms (voice, choice and co-production) are used. However, there are important barriers and limitations in translating the rhetoric into practice, and potential synergy and negative synergy effects can be identified when pursuing the strategies at the same time.

Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed framework further.

The paper includes implications for the development of patient involvement in health care.

This paper fulfills a need to study different types of patient involvement and to develop a theoretical framework for characterizing and analyzing such involvement strategies.

This paper aims to analyse waiting‐time guarantees in the three Scandinavian countries (Denmark, Norway, and Sweden) and to assess whether their current policy designs have strengthened the role of patients in their healthcare systems.

The paper compares official documents and legislation in the three countries. The main findings are that waiting‐time guarantees have generally empowered patients in the Scandinavian health systems. This empowerment is stronger in Denmark and Norway, where formal waiting‐time guarantee rules are applied, than in Sweden, where the guarantee is based on the “softer” regulatory instrument of agreements. While patients are formally empowered in all three countries, and care providers are gradually adjusting to this situation, it is also clear that the practical conditions for empowering patients are not fully in place. The issue of information dissemination is particularly important.

Assessments are based on current regulatory configurations in the three countries, where the process of adapting and implementing the policies is ongoing. These assessments are based on a comparative analysis of the institutional designs. There is no detailed information on how patients use the waiting‐time guarantee.

It is important to consider carefully the information that patients have available in exercising their right to choose healthcare as well as the incentives for providing such information to them.

This is the first systematic comparison of waiting‐time guarantees in the three countries. It is a starting‐point for further research on the introduction of waiting‐time guarantees in public health systems.

Many changes taking place in the public sector raise value questions. Examples are New Public Management, mixed governance forms, globalised recipes on good governance, transnationalisation of public organisations and clashes between Christian and Islamic values in most European states. How to deal with value confusion and value conflicts, thus, is an important challenge for the public manager. Stated in 10 normative prescriptions, various strategies are suggested in the paper. The basic questions addressed are two. How can public management distinguish the central values from those of lesser interest? And how can public management handle value conflicts and organisational design conflicts