2000-2022 年瑞典重病老年人医疗和社会护理服务一体化协调不力的罪魁祸首

IF 1.1 Q3 PUBLIC ADMINISTRATION
Iwona Sobis
{"title":"2000-2022 年瑞典重病老年人医疗和社会护理服务一体化协调不力的罪魁祸首","authors":"Iwona Sobis","doi":"10.2478/nispa-2023-0019","DOIUrl":null,"url":null,"abstract":"Despite numerous attempts to transform Swedish older adult care, similar problems regarding its coordination have persisted over the years. This literature review aims to identify which coordination mechanisms can be perceived as the alleged culprit of poor coordination of integrated health and social services for seriously ill older individuals in Sweden between 2000 and 2022. Classical and contemporary coordination theories are utilised to pinpoint these coordination mechanisms, and the analysis is based on the content of collected articles from this thematic area. This literature review reveals that the following coordination mechanisms are perceived as the primary cause of poor coordination in older adult care: (1) plans, programmes, rules, and standardised work processes. Research has confirmed that decentralisation, the autonomy of regional and local authorities, new regulations implemented in the spirit of NPM, and double principalship have hindered care integration for seriously ill older adults; (2) roles, standardisation of skills, and direct supervision. Neither organisational principal adequately addresses excess employee workloads and an insufficient number of employees providing care services, which generates stress, conflicts, and even occupational burnout among staff. They do not prioritise staff competency development; (3) proximity, feedback, and adjustments through mutual communication. Most studies have shown that communication among staff is crucial to achieving integration, but it could be more effective among staff members involved in providing care. Knowledge about “objects and representations” and “routines and standardisation of outcomes” is somewhat limited and deserves further research.","PeriodicalId":43378,"journal":{"name":"NISPAcee Journal of Public Administration and Policy","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Alleged Culprit of Poor Coordination of Integration of Health and Social Care Services for Very Ill Older Persons in Sweden, 2000-2022\",\"authors\":\"Iwona Sobis\",\"doi\":\"10.2478/nispa-2023-0019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Despite numerous attempts to transform Swedish older adult care, similar problems regarding its coordination have persisted over the years. This literature review aims to identify which coordination mechanisms can be perceived as the alleged culprit of poor coordination of integrated health and social services for seriously ill older individuals in Sweden between 2000 and 2022. Classical and contemporary coordination theories are utilised to pinpoint these coordination mechanisms, and the analysis is based on the content of collected articles from this thematic area. This literature review reveals that the following coordination mechanisms are perceived as the primary cause of poor coordination in older adult care: (1) plans, programmes, rules, and standardised work processes. Research has confirmed that decentralisation, the autonomy of regional and local authorities, new regulations implemented in the spirit of NPM, and double principalship have hindered care integration for seriously ill older adults; (2) roles, standardisation of skills, and direct supervision. Neither organisational principal adequately addresses excess employee workloads and an insufficient number of employees providing care services, which generates stress, conflicts, and even occupational burnout among staff. They do not prioritise staff competency development; (3) proximity, feedback, and adjustments through mutual communication. Most studies have shown that communication among staff is crucial to achieving integration, but it could be more effective among staff members involved in providing care. Knowledge about “objects and representations” and “routines and standardisation of outcomes” is somewhat limited and deserves further research.\",\"PeriodicalId\":43378,\"journal\":{\"name\":\"NISPAcee Journal of Public Administration and Policy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2023-12-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"NISPAcee Journal of Public Administration and Policy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2478/nispa-2023-0019\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC ADMINISTRATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"NISPAcee Journal of Public Administration and Policy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2478/nispa-2023-0019","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC ADMINISTRATION","Score":null,"Total":0}
引用次数: 0

摘要

尽管瑞典曾多次尝试改革老年人护理,但多年来在协调方面一直存在类似问题。本文献综述旨在确定哪些协调机制可被视为 2000 年至 2022 年间瑞典重病老年人综合医疗和社会服务协调不力的罪魁祸首。我们利用经典和现代协调理论来确定这些协调机制,并根据收集到的这一主题领域的文章内容进行分析。文献综述显示,以下协调机制被认为是老年人护理工作协调不力的主要原因:(1)计划、方案、规则和标准化工作流程。研究证实,权力下放、地区和地方当局的自主权、根据国家预防机制精神实施的新法规以及双重主体地位阻碍了重病老年人护理一体化;(2)角色、技能标准化和直接监督。这两个组织主体都没有充分解决员工工作量过大和提供护理服务的员工人数不足的问题,这在员工中产生了压力、冲突,甚至职业倦怠。(3) 通过相互沟通进行接近、反馈和调整。大多数研究表明,工作人员之间的交流对实现一体化至关重要,但在参与提供护理的工作人员之间,交流可以更加有效。关于 "对象和表征 "以及 "常规和结果标准化 "的知识略显有限,值得进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Alleged Culprit of Poor Coordination of Integration of Health and Social Care Services for Very Ill Older Persons in Sweden, 2000-2022
Despite numerous attempts to transform Swedish older adult care, similar problems regarding its coordination have persisted over the years. This literature review aims to identify which coordination mechanisms can be perceived as the alleged culprit of poor coordination of integrated health and social services for seriously ill older individuals in Sweden between 2000 and 2022. Classical and contemporary coordination theories are utilised to pinpoint these coordination mechanisms, and the analysis is based on the content of collected articles from this thematic area. This literature review reveals that the following coordination mechanisms are perceived as the primary cause of poor coordination in older adult care: (1) plans, programmes, rules, and standardised work processes. Research has confirmed that decentralisation, the autonomy of regional and local authorities, new regulations implemented in the spirit of NPM, and double principalship have hindered care integration for seriously ill older adults; (2) roles, standardisation of skills, and direct supervision. Neither organisational principal adequately addresses excess employee workloads and an insufficient number of employees providing care services, which generates stress, conflicts, and even occupational burnout among staff. They do not prioritise staff competency development; (3) proximity, feedback, and adjustments through mutual communication. Most studies have shown that communication among staff is crucial to achieving integration, but it could be more effective among staff members involved in providing care. Knowledge about “objects and representations” and “routines and standardisation of outcomes” is somewhat limited and deserves further research.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
2.70
自引率
18.20%
发文量
10
审稿时长
6 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信