The Evolution and Everyday Practice of Collective Patient Involvement in Europe: An Examination of Policy Processes, Motivations, and Implementations

ISBN-13: 9783319645940 / Angielski / Twarda / 2017 / 350 str.

Alexander Haarmann

Spis treści

Summary

Samenvatting

Zusammenfassung

Sammanfattning

Acknowledgments -- or: The Jigsaw Puzzle

Contents

1. Introduction

1.1. The Underlying Puzzle of the Book

1.1.1. Health system types

1.1.2. Changed roles in healthcare and involvement

1.2. Aim and Question of the Book

1.3. Structure of the Book

2. Patient Involvement -- of Whom, What for, and in What Way?

2.1. Forms of Involvement and Legitimacy

2.2. Equivalents to Patient Involvement

3. A Theoretical Framework for the Study

3.1. Institutionalism

3.1.1. Historical institutionalism

3.1.2. The basic idea about actor-centred institutionalism

3.1.3. Strategic actors

3.2. On Agendas, Ideas, and Paradigms

3.2.1. Ideas

3.2.2. Policy Paradigms

3.3. Conclusions

4. Methodology and Study Design

4.1. To Begin With: What Methodology Suits Question and Theory?

4.2. Case Study Design

4.2.1. Choice of countries and "plausibility probing"

4.2.2. Pitfalls on the way -- Or: What to learn from previous case studies

4.3. Historical Processes

4.4. Methods, Sources, and Analysis

4.4.1. Methods and Sources

4.4.2. Analysis

5. The Netherlands

5.1. Introduction

5.1.1. The Dutch welfare state -- A unique case

5.1.2. Care and healthcare provision -- An overview

5.1.3. A long history of involvement

5.1.4. The political system, parties, and trade unions

5.2. Sources

5.3. Pillarisation and Depillarisation as Societal Preconditions for Involvement

5.4. Developments in the Health Insurance -- A History of Attempted Cost-containment

5.4.1. Growth control by legislative regulation

5.4.2. From sickness funds to private health insurances

5.4.3. Patient rights

5.4.4. Emergence and origins of the patient movement

5.4.5. Patient organisations and involvement on the rise

5.4.6. The rise of popularity of involvement in the political sphere

5.5. The Legislative Process to Collective Patient Involvement

5.5.1. WDFI -- Bill on the Democratic functioning of subsidised healthcare institutions (1984)

5.5.2. WDFZ -- Bill on the Democratic functioning of (health)care institutions (1988)

5.5.3. WMCZ -- Client participation act

5.5.3.1. The legislation process of the WMCZ (1992-1994)

5.5.3.2. The character of the WMCZ

5.5.3.3. The underlying idea is subject to change

5.5.3.4. Further developments

5.5.4. Summary

5.6. Valuation of Implementation

5.6.1. Change over time -- An overview

5.6.2. One law to unite them all

5.6.3. The way of working together

5.6.3.1. Filling the legal framework with content

5.6.3.2. Management -- or: The clash of two lifeworlds

5.6.3.3. Influence, competences, and professionalisation of client councils

5.6.4. Client councils as a countervailing power?

5.6.5. Problems

5.6.5.1. Representativity and legitimacy

5.6.5.2. Sticking point hospitals

5.6.5.3. The relation to patient platforms and related difficulties

5.6.6. Conclusion

6. England

6.1. Introduction6.1.1. The NHS

6.1.2. The political system, parties, and interest groups

6.1.3. Decentralisation

6.2. Sources

6.3. Patient and Public Involvement Within the NHS

6.3.1. Equivalents to patient involvement within the NHS

6.3.2. Formal means of public involvement -- A continuous story of discontinuity

6.3.2.1. The outset of patient involvement -- Community health councils

6.3.2.2. Lack of accountability and legitimacy

6.3.2.3. From unwanted interference to valued input

6.3.2.4. On ill-fitting categories and conceptual difficulties of the existing participatory structure

6.3.3. Summary -- 'Reorganisation as an obsession'

6.4. NHS Foundation Trusts

6.4.1. The NHS trust as precursor -- 'Foundation trust light'

6.4.2. Foundation trusts -- Concept, structure, and supervision

6.4.3. The legislation process -- Legislation on the fast-track

6.4.3.1. Quality of care and performance -- The main target

6.4.3.2. Decentralisation and independence -- The tool

6.4.3.3. Democracy and accountability -- A nice add-on

6.4.4. The legislation process -- Cross-party concerns

6.4.4.1. Party politics and strategic reasoning

6.4.4.2. Reception outside Parliament

6.5. Valuation of Involvement in Foundation Trusts

6.5.1. Monitor -- Assessments and reform

6.5.2. Implementation at the foundation trusts

6.5.2.1. The interplay between monitor and foundation trusts

6.5.2.2. Membership numbers, governors, and representativity

6.5.2.3. Governors and their role in foundation trusts

6.5.2.4. Interplay between governors and boards and governors' involvement

6.6. Summary: Involvement -- A Long Grown Idea Pursued

7. Germany

ntroduction

7.1.1. The healthcare system

7.1.2. The political system, parties, and trade unions

7.2. Sources

7.3. Involvement in the German Healthcare System

7.3.1. Self-governance

7.3.2. Joint federal committee -- The "little legislator"

7.3.3. Other equivalents to patient involvement

7.3.4. Involvement in nursing homes

7.3.4.1. Hamburg

7.3.4.2. Sachsen

7.3.4.3. Valuation of involvement in nursing homes

7.4. Summary

8. Sweden

8.1. Introduction

8.1.1. The healthcare system -- An overview

8.1.2. The political system, parties, and interest groups

8.2. Sources

8.3. Patient Involvement in the Swedish Healthcare System

8.3.1. Equivalents to patient involvement

8.3.1.1. Individual patient rights

8.3.1.2. The system of ombudsman8.3.1.3. Patient organisations

8.3.2. The emergence of collective involvement

8.3.3. Involvement via user organisations

8.3.3.1. A change in attitude towards involvement

8.3.3.2. Historical legacies

8.3.3.3. The primacy of democratically elected politicians

8.3.3.4. Zeitgeist, the economy, and a new general of politicians

8.3.3.5. Choice -- Different means to the same end

8.3.4. Other reasons for a late emergence of patient involvement

8.3.4.1. About authoritarianism and independence

8.3.4.2. Too busy to...

8.3.5. Other forms of involvement

8.4. Valuation of Patient Involvement by the Interviewees

8.4.1. Topics raised and the way of working together

8.4.2. Development of patient organisations

8.4.3. Representativity and legitimacy

8.5. Summary

8.6. An Outlook

9. Comparison -- Bringing Four Cases Together

9.1. Empirical Findings and Commonalities

9.1.1. Emerging forms of involvement and commonalities

9.1.2. More commonalities -- The market, NPM, and patients as customers

9.1.3. Actor relations

9.1.4. Historical institutionalism

9.1.5. Ideas

9.2. On Patients, Users, Consumers, and Customers

9.3. Perception -- The Undervalued Factor

9.4. Policy Paradigms and Path Breaks -- Fuzzy Assumptions and a Vague Relation

9.5. Towards a Revised Model of Policy Processes

9.6. Four Countries Revisited

9.6.1. The Netherlands

9.6.2. England

9.6.3. Germany

9.6.4. Sweden

9.7. Four Countries, Two Types of Involvement, and Beyond

9.8. General Implications -- Involvement and Beyond

9.9. Conclusions

Bibliography

A. Appendix -- Interview Guidelines

A.1. The Netherlands

A.2. England

A.3. Germany

A.4. Sweden

B. Appendix -- Codes

B.1. The Netherlands

B.2. England

B.3. Germany

B.4. Sweden

C. Appendix -- Additional Material

C.1. International Names of Places

C.2. Calculation of Interrater Reliability

C.4. The Netherlands

C.5. England

C.6. Germany

C.7. Sweden

List of Tables

List of Figures

List of Abbreviations

O autorze

Alexander Haarmann has a background in sociology. His main interest lies in the analysis and international comparison of social policies as well as its reforms. Within this general field, his focus is on health and policies on healthcare and care. Working together with colleagues from different disciplines and countries has contributed to numerous aspects and additional perspectives: Over time, he has, amongst other things, worked on the structures and actors of healthcare systems, the provision of healthcare and care, social and health related inequalities, as well as healthcare from a patient perspective.

Blurb

This timely study analyzes social, economic, political, provider, and patient factors shaping collective patient involvement in European health care from the postwar period to the present day. Examining representative countries England, the Netherlands, Germany, and Sweden, it documents the roles of providers and legislatures in facilitating consumer involvement, and the varied forms of patient input into hospital operations. These findings are compared and contrasted against the intent and ideals behind patient involvement to assess the effectiveness of implementation policy, strengths and drawbacks of patient participation, and patient satisfaction and outcomes. The book’s conclusions identify emerging forms of patient participation and predict the impact of health policy on the future of European collective patient involvement.

 

Included in the coverage:

 

·         Patient involvement: who, what for, and in what way?

·         The Netherlands: the legislative process to collective patient involvement

·         England: formal means of public involvement—a continuous story of discontinuity

·         Germany: Joint Federal Committee—the “Little Legislator”

·         Sweden: reasons for a late emergence of patient involvement

·         Lessons to be learned from implementing patient involvement

 

The Evolution and Everyday Practice of Collective Patient Involvement in Europe will interest and inspire scholars and researchers in diverse fields, including social policy, sociology, political sciences, and nursing studies, as well as patient organizations, policymakers, and healthcare providers.