Health system reforms—Toward a framework for international comparisons
Health care reform efforts internationally are focused more on efficiency than on effectiveness or equity. We lack a coherent theoretical framework for understanding those reforms or for engaging in comparative research. This paper presents some theoretical ideas that could contribute to such a fram...
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| Veröffentlicht in: | Social science & medicine (1982) 1996-09, Vol.43 (5), p.637-654 |
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| container_title | Social science & medicine (1982) |
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| creator | Twaddle, Andrew C. |
| description | Health care reform efforts internationally are focused more on efficiency than on effectiveness or equity. We lack a coherent theoretical framework for understanding those reforms or for engaging in comparative research. This paper presents some theoretical ideas that could contribute to such a framework. A model constructed from expert opinion suggests that hegemonic systems, national systems and medical care systems all contribute, with specific elements identified in each. Three sociological ideas are suggested: a model of trends leading to a fiscal crisis and a crisis and a crisis of alienation; communities, professions and markets as ideal typical organizational alternatives; global post-Fordist and world systems theories; and hegemonic projects. Together these could explain the timing, speed and direction of health care reform efforts throughout the world. |
| doi_str_mv | 10.1016/0277-9536(96)00151-7 |
| format | Article |
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We lack a coherent theoretical framework for understanding those reforms or for engaging in comparative research. This paper presents some theoretical ideas that could contribute to such a framework. A model constructed from expert opinion suggests that hegemonic systems, national systems and medical care systems all contribute, with specific elements identified in each. Three sociological ideas are suggested: a model of trends leading to a fiscal crisis and a crisis and a crisis of alienation; communities, professions and markets as ideal typical organizational alternatives; global post-Fordist and world systems theories; and hegemonic projects. 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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; RePEc; Elsevier ScienceDirect Journals Complete; Sociological Abstracts |
| subjects | Biological and medical sciences Comparative Analysis Crossnational studies Developing Countries General aspects Health Care health care reform Health Care Reform - organization & administration Health Policy Health services health system reforms health system reforms health care reform Health systems. Social services Humans International Cooperation Medical sciences Medicine Methodology (Philosophical) Models, Organizational National Health Programs Policy Reform Public health. Hygiene Public health. Hygiene-occupational medicine Reform Reforms Social reform Social research Social sciences Socioeconomic Factors |
| title | Health system reforms—Toward a framework for international comparisons |
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