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– This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA.
This study aims to explore the causes and consequences of media scandals involving nursing homes for older persons in Canada, Norway, Sweden, the UK and the USA.
This study uses a descriptive case-study methodology which provides an in-depth, focused, qualitative analysis of one selected nursing home scandal in each jurisdiction. Scandals were selected on the basis of being substantive enough to potentially affect policy. An international comparative perspective was adopted to consider whether and how different social, political and economic contexts might shape scandals and their consequences.
This study found that for-profit residential care provision as well as international trends in the ownership and financing of nursing homes were factors in the emergence of all media scandals, as was investigative reporting and a lack of consensus around the role of the state in the delivery of residential care. All scandals resulted in government action but such action generally avoided addressing underlying structural conditions.
This study examines only the short-term effects of five media scandals.
While there has been longstanding recognition of the importance of scandals to the development of residential care policy, there have been few studies that have systematically examined the causes and consequences of such scandals. This paper contributes to a research agenda that more fully considers the media's role in the development of residential care policy, attending to both its promises and shortcomings.
– The purpose of this paper is to describe and analyse ways of organizing integrated care for older persons in Sweden during the past decade.
The purpose of this paper is to describe and analyse ways of organizing integrated care for older persons in Sweden during the past decade.
The data consist of 62 cases of development work, described in official reports. A meta-analysis of cases was performed, including content analysis of each case. A theoretical framework comprising different forms of integration (co-ordination, contracting, co-operation and collaboration) was applied.
Co-operation was common and collaboration, including multiprofessional teamwork, was rare in the cases. Contracting can be questioned as being a form of integration, and the introduction of consumer choice models appeared problematic in inter-organization integration. Goals stated in the cases concerned steering and designing care, rather than outcome specifications for older persons. Explicit goals to improve integration in itself could imply that the organizations adapt to strong normative expectations in society. Trends over the decade comprised development of local health care systems, introduction of consumer choice models and contracting out.
Most cases were projects, but others comprised evaluations of regular organization of integrated care. These evaluations were often written normatively, but constituted the conditions for practice and were important study contributions.
Guiding clinical practice to be aware of importance of setting follow-up goals.
Awareness of the risk that special funds may impede sustainable strategies development.
A theoretical framework of forms of integration was applied to several different strategies, which had been carried out mostly in practice. The study contributes to understanding of how different strategies have been developed and applied to organize integrated care, and highlights some relationships between integration theory and practice.