What frames Quality Registers in Swedish Health Care: an institutional approach
2011 (English)In: Proceedings from 14th Uddevalla Symposium, 2011 Entrepreneurial Knowledge, Technology and Transformation of Regions / [ed] Iréne Bernhard, Linköping: Linköping University Electronic Press, 2011, 1-19 p.Conference paper (Other academic)
Quality issues strike the classical conflict in a democratic health-care deliverysystem of different interests among the politicians, the medical profession andpublic officials. This cannot be studied as a cut-off whiz. Quality registers havedeveloped over the past 40 years. Therefore, this paper puts the innovation ofquality registers in an institutional perspective. Two things are essential in thispaper. First, this paper reviews the emergence of quality registers in Swedish healthcare as an effect of institutional arrangements. Second, it analyses the interactionof diverse factors in different institutional settings and logics. The relevant data forthe study was collected from official/unofficial policy documents and key actorinterviews.The empirical findings show that three different waves of development can betraced in history that has highly affected the development of quality registers. Italso shows that medical quality is framed and determined by physicians in line withprofessional knowledge and by the primary institutional logic of quality in medicalcare. However, organisational quality in health care is framed by the logic ofpublic equity of access based on a third party payer and the logic of managerialcontrol. These two paths of quality developments are now federating in aninstitutional logic of transparency. The contribution of this paper is importantbecause it produces insights in different institutional logics, which frames the riseof the two quality paths and the problems they have to face in order to merge. It also enhances the existing knowledge that institutions matter.
Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2011. 1-19 p.
, Research Reports 2011:05 University West, ISSN 1653-7831 ; 2011:05
health care, institutional change, quality, innovation
Public Administration Studies
IdentifiersURN: urn:nbn:se:liu:diva-88746ISBN: 978-91-977943-2-9OAI: oai:DiVA.org:liu-88746DiVA: diva2:606043
14th Uddevalla Symposium, 2011 Entrepreneurial Knowledge, Technology and Transformation of Regions, June 16-18, Bergamo, Italy