495 research outputs found
After decades of decentralisation, the state now has a growing role in Nordic health systems
No full textThe onset of the financial crisis has forced many European governments into reforming public services, including healthcare. Despite this economic turmoil, the Nordic states have so far been insulated from some of the pressures faced in other European countries. Richard Saltman, Karsten Vrangbaek, Juhani Lehto and Ulrika Winblad look at how the Nordic countries have moved to decentralise the control of healthcare provision over the last fifteen years. They suggest that despite their insulation from the crisis, Nordic governments may be moving towards more centralised models of healthcare provision
Patient involvement in Danish health care
No full textPURPOSE: 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.DESIGN/METHODOLOGY/APPROACH: 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.FINDINGS: 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.RESEARCH LIMITATIONS/IMPLICATIONS: Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed framework further.PRACTICAL IMPLICATIONS: The paper includes implications for the development of patient involvement in health care.ORIGINALITY/VALUE: 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.</p
Commentary to Adam Oliver’s 'Incentivising improvements in health care delivery'
No full textThe commentary discusses key issues for assessment of performancemanagement within health care. It supports the ambition to develop more realisticunderstandings of performance management based on insights from behavioraleconomics as suggested by Adam Oliver. However, it also points to several pitfallsand potential risks to consider when doing so. The commentary concludes that thisis a promising field, but further research is needed to support the development ofpolicy instruments
The interplay between central and sub-central levels: the development of a systemic standard based programme for governing medical performance in Denmark
No full textPublic values and the search for ‘informed choice’ in maternity services during the period 1991-2022 in England
No full textThis chapter uses a case study of the pursuit of ‘informed choice’ in maternity services in England during the period 1991-2022 to examine what impacts on the creation of societal value. De Graaf et al (2016) identified responsive, performing and proper governance as three types of governance which are often sites of societal value conflict. They provide the framework of analysis. There are several reasons why a study of the ‘informed choice’ in maternity services in England is useful for trying to understand societal conflict. In the last 20 years, there has been a move away from medical interventions to a natural birth approach, due to demands made by women’s campaigning groups in the 1980s and 1990s. Health professionals have had to respond to these demands. At the same time, the National Health Service (NHS) adopted public management reforms with the introduction of targets, increased use of evidence-based medicine to determine clinical practice, accompanied by budgetary pressures. These changes have brought politicians, managers and health professionals into uneasy alliances, all working towards slightly different versions of public value. Maternity services are significantly different to other health care services because women are not technically ill, although there are elements of risk involved in giving birth. The analysis will examine the changing roles of professionals, particularly midwives, during this period. This chapter has drawn on an analysis of reports and strategies into maternity services and ‘informed choice’ between 1991 and 2022. The views of women and midwives are examined by drawing on academic research and research used to inform campaigning
County Level Responses to the Introduction of DRG Rates for "Extended Choice" Hospital Patients in Denmark
No full textSigmund Freud contra Helga Grebing - Kommentierende Anmerkungen zu den Beiträgen von Max Bloch, Karsten Rudolph, Meik Woyke und Walter Mühlhausen
No full textConcentrating on the contributions of Max Bloch, Karsten Rudolph, Meik Woyke and Walter Mühlhausen the author sums up the contributions of this volume in order to reflect on the current state of research in the field of the historiography of biographies of leading social democrats. He discusses remaining lacunae in research and develops perspectives for future research
County level responses to the introduction of DRG rates for "extended choice" hospital patients in Denmark
No full textLessons and long-term implications of the covid-19 response in Denmark from a resilience perspective: Karsten Vrangbæk
No full textThe paper focuses on crisis responses and resilience within hospitals. The study is based on structured expert interviews with medical directors in selected hospital departments in two of the five regions of Denmark and primary care physicians in the same regions. We investigate stage 3 (Shock impact and management) and stage 4 (Recovery and learning) within hospital organizations using Denmark as case country, and we pay particular attention to issues of “organisational learning”, “purchasing flexibility and reallocation of funding”, “distribution of human and physical resources” and “motivated and well-supported workforce”. Particular attention is paid to care for patients with chronic care needs and lessons for the long-term resilience building in the health system. The study highlights strategic choices and lessons for the long-term resilience within hospitals. It demonstrates, how the initial strategy of organizing specific COVID-19 response units was abandoned relatively early, as it appeared more efficient to integrate COVID-19 patients in the regular specialized department structure. Emergency wards experienced increasing pressure during the pandemic as primary care clinics were referring (too) many patients suspected of COVID-19. This raises questions about capacity and relations between primary and specialized care in crisis situations. Management of human resources is crucial. While the initial phases of the pandemic response were characterized by flexibility and “team-spirit”, there has been a negative long-term impact particularly among the nursing staff, where burnouts and attrition are major issues. Pandemic crises place significant strain on health systems and personnel. This raises issues about communication of strategies and principles for organizing efforts. The Danish health system managed the crisis adequately, but there are also lessons that should be learned regarding long-term implications and preparedness for future crises
B --> ([rho]/[omega]) [gamma] at BaBar
No full textThesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Physics, 2007.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.In title on title page, "[right arrow] appears as the symbol; and "[rho]", "[omega]" and "[gamma]" appear as lower-case Greek letters.Includes bibliographical references (leaves 203-205).This document describes the measurements of the branching fractions and isospin violations of the radiative electroweak penguin decays B [right arrow] ([rho]/[omega]) [gamma] at the asymmetric energy e+e- PEP-II collider with the BABAR detector. Together with the previously measured branching fractions of the decays ... the ratio of CKM-matrix elements Vtd=Vts are extracted and the length of the far side of the unitarity triangle is determined.by Karsten Köneke.Ph.D
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