Abstract:
:This paper takes an overview of the organizational and managerial literature on recent large-scale change efforts within health care organizations. Such literature refers to issues of enhanced policy significance, as a succession of such changes has swept through health care, at an international level. Interpretive and case study method have been widely employed in this field. While the literature is emergent, key empirical concerns can be identified: (1) Changing roles and relationships, with the rise of management and the challenge to clinical domination; some argue that radical deprofessionalization now is evident, while others take a more nuanced view. (2) The impact of marketization, with health care becoming more of a commodity; various models of a health care 'quasi market' have been formulated. (3) Understanding the process of change in health care organizations, such as the development of a management of change literature. New theoretical frameworks have been developed, notably 'the reform cycle' as a way of understanding progressive cycles of organizational reform, the impact on health care of the rise of the new public management, and examining the demedicalization thesis through the more generic literature on professions. The paper concludes with a discussion of what this research base could contribute to policy-making.
journal_name
J Health Serv Res Policyjournal_title
Journal of health services research & policyauthors
Ferlie Edoi
10.1177/135581969700200310subject
Has Abstractpub_date
1997-07-01 00:00:00pages
180-9issue
3eissn
1355-8196issn
1758-1060journal_volume
2pub_type
杂志文章,评审abstract:OBJECTIVES:To establish current guidance and practice in UK on presentation of indirect comparison and mixed treatment comparison analyses; to provide recommendations to improve indirect comparison/mixed treatment comparison reporting and to identify research priorities for improved presentation. METHODS:Existing inst...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819613498379
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:Limited resources mean that decision-makers must set priorities among competing opportunities. Programme budgeting and marginal analysis (PBMA) is an economic approach that focuses on optimizing benefits with available resources. Accountability for reasonableness (A4R) is an ethics approach that focuses on en...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581906775094280
更新日期:2006-01-01 00:00:00
abstract::Almost everything you know about heroin addiction is wrong. Not only is it wrong, but it is obviously wrong. Heroin is not highly addictive; withdrawal from it is not medically serious; addicts do not become criminals to feed their habit; addicts do not need any medical assistance to stop taking heroin; and contrary t...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008022
更新日期:2008-04-01 00:00:00
abstract::This article raises the concern that biobanks are failing to realize the expected research and health service outcomes. Rather than biobanking, we have been engaging in 'biohoarding', where building a quantifiable collection of tissue samples is the primary basis of the bio-resource. The root cause of 'biohoarding' is...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819615599014
更新日期:2016-04-01 00:00:00
abstract::We review the foundations of resource allocation rules based on cost-effectiveness information. Comprehensive approaches, where a total budget is allocated in one go, require estimation of the costs and effects of all available health care programmes, which is unlikely to be practical. A common alternative is to asses...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/1355819042250177
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVES:Successful partnership working has theoretically been linked to improvements in service delivery and is dependent on the strength of the partnership, trust, communication, professional roles and resource sharing. Empirical evidence to confirm the relationships between these factors and improved service provi...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819612473584
更新日期:2013-07-01 00:00:00
abstract::The economic evaluation of health care technologies has a key role within the new National Health Service health technology assessment process. There has, however, been little discussion of the best way of combining economic and clinical research. Economic evaluation should be iterative, generating progressively firme...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969700200107
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of a risk factor checklist and training video for general practitioners in reducing inter-practice variation and improving the appropriateness of referrals (assessed by their positive predictive value or PPV) of patients with suspected otitis media with effusion (OME or 'glue ear') to ...
journal_title:Journal of health services research & policy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1258/1355819011927387
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Scholarship cites health care managers (HCMs) as not using research evidence in their management practice. The purpose of this review was to evaluate the effectiveness of interventions to enhance HCMs use of research evidence in practice. METHODS:We carried out a systematic review and focus groups to valida...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/1355819618786764
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:to determine the extent and nature of the decisions individuals are asked to make as in-patients, and whether doctors, nurses, other health care practitioners, and housekeepers engaged in routine (non-emergency) medical assessments, investigations and treatments, or acts of personal care observe the Referenc...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.009148
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:To examine the influence of the English National Health Service (NHS) South and West (S&W) region Development and Evaluation Committee (DEC) technology appraisal reports on purchasing and clinical decisions in the S&W and elsewhere in the NHS, and to estimate the cost of the DEC process. METHODS:Two postal ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960300800106
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:To compare the cost-effectiveness of four third molar guideline implementation strategies. METHODS:Fifty-one dental practices in Scotland were randomized to one of four implementation strategies. The effectiveness of the strategies was measured by general dental practitioners' compliance with the guideline....
journal_title:Journal of health services research & policy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1258/1355819054339031
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVES:Increasingly health care performance data are being disseminated in the form of 'league tables' of health care providers, with the implication that such publication helps purchasers select the better providers, and spurs providers into improvements. This paper examines progress to date. METHODS:Three stages...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/135581969800300111
更新日期:1998-01-01 00:00:00
abstract::There has been much speculation about whether the National Institute for Health and Clinical Excellence (NICE) has, or ought to have, a 'threshold' figure for the cost of an additional quality-adjusted life-year above which a technology will not be recommended for use. We argue that it is not constitutionally appropri...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907779497567
更新日期:2007-01-01 00:00:00
abstract::Continuity of care is concerned with the quality of care over time. There are two important perspectives on this. Traditionally, continuity of care is idealized in the patient's experience of a 'continuous caring relationship' with an identified health care professional. For providers in vertically integrated systems ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581906778476490
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:Randomized controlled trials are important for evaluating health care interventions, but recruitment can be difficult. Studies of potential participants' perspectives on trial participation are accumulating, but their collective contribution is not obvious. In 2007, we conducted a meta-ethnographic synthesis...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/1355819613483126
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:To demonstrate the benefits of applying meta ethnography to the synthesis of qualitative research, by means of a worked example. METHODS:Four papers about lay meanings of medicines were arbitrarily chosen. Noblit and Hare's seven-step process for conducting a meta ethnography was employed: getting started; ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581902320432732
更新日期:2002-10-01 00:00:00
abstract::People with serious and persistent mental illness require a range of community services typically provided by different specialized agencies. At the clinical level, assertive team case management is the strategy commonly used to achieve integration of services across specialized sectors. The USA also has used various ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969700200206
更新日期:1997-04-01 00:00:00
abstract:INTRODUCTION:Levels of management staffing in the UK National Health Service (NHS) have received considerable political and media attention in the last four years or so. Both the previous and current governments committed themselves to reducing management expenditure in the health service, and significant cuts appear t...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969900400104
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:To assess the role of economics, in combination with clinical judgement, for setting research priorities, using osteoporosis prevention (and, as a result, hip fracture prevention) as an example. METHODS:Modelling the cost and effectiveness of each of six potential interventions to prevent hip fractures over...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969600100305
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVES:To determine the extent to which reports of Cochrane reviews recommend the need for further research and, if so, the extent to which they make suggestions regarding that research. METHODS:We examined all 2535 reviews in Issue 4, 2005 of The Cochrane Library. Each review was categorized on the basis of wheth...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907780279648
更新日期:2007-04-01 00:00:00
abstract::The incorporation of genetics into health services research has largely floundered, despite the rapidly accelerating availability of, and access to, such data. This is expected given the ethical questions involved. However, using these new resources robustly to examine population choices when it comes to health insure...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819616664374
更新日期:2017-01-01 00:00:00
abstract::This essay considers some limitations of programme theory evaluation in relation to healthcare policies. This approach, which seeks to surface 'programme theories' or construct 'logic models', is often unable to account for empirical observations of policy implementation in real-world contexts. I argue that this failu...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819618779614
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:To explore the relationship between ethnicity, socioeconomic deprivation and utilization of general practice. METHODS:Data routinely collected by New Zealand general practices in 2001 were analysed using generalized linear regression. RESULTS:The mean number of doctor consultations for registered individua...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581906777641721
更新日期:2006-07-01 00:00:00
abstract:OBJECTIVES:To assess whether it is feasible to elicit patients' preferences for treatments and then to proceed with randomisation which may allocate those with preferences to their less preferred treatment; and to describe which prognostic variables were associated with such preferences within the context of a randomis...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969600100403
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVES:To compare open heart surgery services provided by public and private hospitals in Catalonia (Spain) according to case mix, procedures undergone and surgical mortality. METHODS:Data on all adult patients undergoing open heart surgery procedures were collected prospectively in a sample of public and privatel...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969900400204
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To evaluate how UK maternity unit protocols conformed to national recommendations for preventing early-onset neonatal Group B Streptococcal (GBS) disease. METHODS:In December 2005, all UK obstetric maternity units were contacted and asked to provide a copy of their protocol on preventing GBS disease. Informa...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2007.007144
更新日期:2008-04-01 00:00:00
abstract::The study, first published in 2003, looks at the root causes of adverse events and near misses in obstetrics at seven hospital maternity units by interviewing 93 members of staff, identifying the areas of mismanagement in each case and thematically analysing them. ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.09s106
更新日期:2010-01-01 00:00:00
abstract::Health services researchers have an important role to play in helping health care systems around the world provide high quality, affordable services. However, gaps between the best evidence and current practice suggest that researchers need to work in new ways. The production of research that meets the needs and prior...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819617714815
更新日期:2017-10-01 00:00:00
abstract::Health services research must continually address the question: Under what conditions may data not collected specifically for research, such as primary medical data, be re-used for research without compromising the privacy of the data-subjects? For secondary use of data in research there are basically three options. O...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581903766468800
更新日期:2003-07-01 00:00:00