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- Bliksvær, Trond, et al.
(författare)
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Health care services for older people in COVID-19 pandemic times – A Nordic comparison
- 2024
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Ingår i: Scandinavian Journal of Primary Health Care. - 0281-3432 .- 1502-7724. ; 42:1, s. 144-155
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Tidskriftsartikel (refereegranskat)abstract
- Objective: to explore the Nordic municipal health and care services’ ability to promote principal goals within care for older people during the cOViD-19 pandemic.Design and setting: two surveys were conducted among managers of municipal health care services for older people in Denmark, Finland, Norway and sweden; the first around 6 months into the pandemic (survey 1), and the second around 12 months later (survey 2). Data were analysed through descriptive statistics, and multiple regression (Ols).Subjects: 1470 (survey 1, 2020) and 745 (survey 2, 2021) managers. 32% in home care, 51% in nursing homes, 17% combined.Results: in all countries the pandemic seems to have had more negative impact on eldercare services’ ability to promote an active and social life, than on the ability to promote or enhance older people’s mental and physical health. the regression analysis indicates that different factors influence the ability to promote these goals. Managers within nursing homes reported reduced ability to promote mental and physical health and an active social life to a significantly lower degree than managers of home care. the effect of three prevention strategies (lock down, testing, and/or organisational change), were explored. Organisational change (reorganize staff and practice, restrict use of substitutes) tended to impact the units’ ability to promote a social life in a positive direction, while lock down (areas, buffets etc) tended to impact both the ability to promote mental/physical health and a social life in a negative direction.Conclusion: Measures that can improve opportunities for an active and social life during a pandemic should have high priority, particularily within home care.KEY POINTS• it is important to learn from how the cOViD-19 outbreak in 2020 affected the municipal health and care services’ ability to achieve principal goals within care for older people.• the pandemic had a more negative impact on the services’ ability to promote an active and social life, than on their ability to promote or enhance mental and physical health.• Measures that can improve opportunities for an active and social life during a pandemic situation should have high priority, particularily within home-based care.
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2. |
- Lindholst, Andrej Christian, et al.
(författare)
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11. Where is Municipal Marketisation Heading? Experiences from England and Scandinavia
- 2019
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Ingår i: Presentation av bokkapiteltext på NORKOM-konferensen i Åbo 29-30 november, 2019..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Marketisation is commonly understood as a key component in the new public management (NPM) model for public management reform. However, negative experiences, newer reform trends and local circumstances have challenged the NPM and raised the question of whether reforms have entered a post-NPM era. In this chapter, we explore and compare the impact of marketisation on the organisation of local service delivery and address whether newer reform trends in the post-NPM era are transforming contemporary marketisation. Our study takes place in the context of local park and road services across England, Sweden, Denmark and Norway and draws upon original survey data collected from mid-level managers in 201416. The chapter concludes that marketisation is widespread but not dominant within our study’s context. It is also being transformed to some extent by newer and different reform trends. In perspective, we find that marketisation is an evolving reform practice, which trajectories depend on local contextual circumstances and adaption of newer reform ideas.
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3. |
- Lindholst, Andrej Christian, et al.
(författare)
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Introducing the Research Setting: Four Countries and Two Local Services
- 2020
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Ingår i: Marketization in Local Government: Diffusion and Evolution in Scandinavia and England. Andrej Christian Lindholst, Morten Balle Hansen (red.). - Cham, Switzerland : Palgrave Macmillan, Springer Nature. - 9783030324773 ; , s. 79-98
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Bokkapitel (refereegranskat)abstract
- In comparative analysis of public management reforms, the general characteristics of countries and service contexts wherein reforms are implemented are important when examining and interpreting similarities and differences in the outcomes of reforms (Christensen and Lægreid, 2007; Greve et al., 2016; Pollitt and Bouckaert, 2011). When taking a comparative perspective, key characteristics of the politico-administrative system, such as Local Government structure, can provide a filter shaping the mix of policy instruments and organizational possibilities for implementing marketization within various services sectors. Similarly, the characteristics of the services sectors, such as…, are expected to provide a second filter shaping the outcomes from marketization. The country context of the book is represented by England and the three Scandinavian countries of Denmark, Norway and Sweden while the service context is represented by local park and road services. In the comparative perspective of the book, the country context varies while the service sector context is invariant. This chapter provides an overview and comparison of the general characteristics of the four countries and service context. The overview of the countries and service context focuses on relatively stable characteristics and their differences and similarities across the countries. The chapter is organised in two main sections. The first section provides an overview of the general characteristics of Local Governments in the four countries. The second section provides an overview of local park and road services in the four countries.
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4. |
- Lindholst, Andrej Christian, et al.
(författare)
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Patterns and Variations of Marketization Compared
- 2020
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Ingår i: Marketization in Local Government: Diffusion and Evolution in Scandinavia and England. - Cham, Switzerland : Palgrave Macmillan, Springer Nature. - 9783030324773 ; , s. 197-221
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Bokkapitel (refereegranskat)abstract
- In chapters 5 to 8, we provided an overview of trajectories of marketization and their impact on the organization and provision of municipal park and road services in each of the four countries: England and the three Scandinavian countries Sweden, Denmark and Norway. The country-based studies highlighted particular characteristics of marketization and how marketization has found its way within municipal park and road services. One key finding appearing from a cross-reading is that marketization is characterized by substantial variations across the four countries. The implementation of marketization both diverge and converge across the national contexts in unexpected ways. For example, the purposes for involving private providers and markets in public service delivery may not be so tightly coupled to cost concerns as envisioned in core new public management (NPM) reform models. Private providers and markets may also have equally important, albeit different, roles in public service delivery across radical and more cautious reform countries. Lastly, countries renowned for strong emphasis on marketization in their past reform trajectories may not appear that marketized after all – even within spearhead sectors such as municipal park and road services. Also, the study of economic outcomes from contracting out of park and road services in chapter 9 found substantial variations, including average cost savings in Denmark, a neutral effect on costs levels in Sweden and average cost increases in Norway, even after controlling for standard explanations such as the level of competition and contracting strategy. These variations in outcomes call for a careful appreciation of the comparative characteristics of the wider institutional context for marketization across different groups of countries. To gain a better understanding of similarities and differences in the patterns and variations in contemporary marketization in a comparative perspective, we have addressed the following two research questions: 1) To which degree do patterns and variations in contemporary marketization within municipal park and road services diverge (or converge) across England and the three Scandinavian countries, and 2) can any distinctive variants of marketization be identified across the four countries (or is marketization converging on a common model)? To answer these questions, we compare patterns and variations of contemporary marketization within a series of statistical analyses of comparable INOPS survey data from each of the four countries (see chapter 4 for details on data and methods). The INOPS survey data makes it possible to explore and carry out formal statistical tests of whether municipalities across the four countries converge or diverge in their implementation of features from different marketization models within the park and road services. The comparison extends the analysis of the implementation of marketization within municipal park and road services from the single-country perspectives found in chapters 5 to 8 toward a formalized comparative country analysis based on statistical techniques.
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5. |
- Lindholst, Andrej Christian, et al.
(författare)
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Research design, materials and methods
- 2020
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Ingår i: Marketization in Local Government: Diffusion and Evolution in Scandinavia and England. Andrej Christian Lindholst, Morten Balle Hansen (red.). - Cham, Switzerland : Palgrave Macmillan, Springer Nature. - 9783030324773 ; , s. 61-78
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Bokkapitel (refereegranskat)abstract
- The phenomenon of marketization holds no lack of earlier research and has been researched through various empirical strategies. In this chapter we present the research strategy and primary data sources for the book. We highlight the relevance of the methodological approach within the range of empirical strategies employed in earlier research. Our research strategy is comparative in its outlook and integrates longitudinal and cross-sectorial analyses of experiences with marketization of park and road services within and across the four countries of England, Denmark, Sweden and Norway based on a mix of quantitative and qualitative data. A key feature of the book’s research strategy is that marketization is researched with an eye to the importance of differences in national context for the evolution and diffusion of marketization. The comparative character of our research strategy locates and distinguishes our contributions within a handful of strategies for contextualizing the phenomenon of marketization. In the marketization literature we find four major strategies. First, a group of studies focuses on experiences within a single country. One example is Kettl’s (1993) case-based study of experiences with the use of private markets and competition in the US. Another example is the collection of evidence on the impact from marketization on Swedish welfare found in the anthology edited by Hartmann (2011). Second, a group of studies looks beyond individual country contexts and starts with a global outlook on marketization. One example is Simmons and Elkins’ (2004) study of the diffusion of marketization across nations as part of a global neoliberal movement. Third, a group of studies embeds marketization as part of a more general research interest in public sector reforms. Greve (2006), for example, provides an overview of public management reform in Denmark including an assessment of the relative emphasis on marketization. Pollitt and Bouckaert’s (2011) contribution is another example, where marketization is viewed as part of the historical trends in public management reform in a comparative analysis of OECD countries. Finally, a group of studies connect or integrate experiences with marketization across two or more countries. One example is Greer et al.’s (2017) comparison of the different ways public employment services has been re-organized by adoption of market-based coordination mechanisms in three European countries. Another example is Alonso et al.’s (2017) study, using statistics from several European countries for a general evaluation of whether greater private involvement has led to reduced expenditures in services provided by central governments. A key difference between these two studies is the careful attention to the importance of national context in former while the latter evaluate financial performance across several countries in a highly generalized way. The empirical content and details of the four highlighted research strategies are further diversified by, for example, the number and type of government or service sector(s), the type of data sources and materials, and the applied analytical methods. In the midst of the wealth of research on the phenomena of marketization, however, we find that truly cross-national comparative analyses of organizational developments paying attention to historical-institutional contexts are scare.
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