Divergent notions of "quality" in healthcare policy implementation: a framing perspective.
J Health Organ Manag
; ahead-of-print(ahead-of-print)2021 Jan 07.
Article
em En
| MEDLINE
| ID: mdl-33440089
ABSTRACT
PURPOSE:
This paper examines how "quality" was framed in the design and implementation of a policy to reform hospital funding and associated care delivery. The aims of the study were (1) To describe how government policy-makers who designed the policy and managers and clinicians who implemented the policy framed the concept of "quality" and (2) To explore how frames of quality and the framing process may have influenced policy implementation. DESIGN/METHODOLOGY/APPROACH:
The authors conducted a secondary analysis of data from a qualitative case study involving semi-structured interviews with 45 purposefully selected key informants involved in the design and implementation of the quality-based procedures policy in Ontario, Canada. The authors used framing theory to inform coding and analysis.FINDINGS:
The authors found that policy designers perpetuated a broader frame of quality than implementers who held more narrow frames of quality. Frame divergence was further characterized by how informants framed the relationship between clinical and financial domains of quality. Several environmental and organizational factors influenced how quality was framed by implementers. ORIGINALITY/VALUE As health systems around the world increasingly implement new models of governance and financing to strengthen quality of care, there is a need to consider how "quality" is framed in the context of these policies and with what effect. This is the first framing analysis of "quality" in health policy.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Formulação de Políticas
/
Política de Saúde
Tipo de estudo:
Prognostic_studies
/
Qualitative_research
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Health Organ Manag
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Canadá