Perspectives on the underlying drivers of urgent and emergency care reconfiguration in Ireland

التفاصيل البيبلوغرافية
العنوان: Perspectives on the underlying drivers of urgent and emergency care reconfiguration in Ireland
المؤلفون: Sheena McHugh, Conor Foley, Orla Healy, Elsa Droog, Maria B. Boyce, John Browne, Claire M. Buckley
المصدر: The International Journal of Health Planning and Management
بيانات النشر: Wiley, 2017.
سنة النشر: 2017
مصطلحات موضوعية: Centralisation, stakeholder perspectives of change, Emergency Medical Services, Economic growth, finance, Business system planning, Experiential learning, Interviews as Topic, 03 medical and health sciences, Politics, 0302 clinical medicine, Argument, Political science, Humans, 030212 general & internal medicine, Research Articles, Qualitative Research, Evidence, urgent and emergency care reconfiguration, evidence, business.industry, 030503 health policy & services, Health Policy, Stakeholder, Control reconfiguration, Stakeholder perspectives of change, Technocracy, Public relations, Health Planning, Female, Urgent and emergency care reconfiguration, politics, 0305 other medical science, business, Ireland, Finance, Research Article
الوصف: SummaryBackground There is an increasing tendency to reconfigure acute hospital care towards a more centralised and specialised model, particularly for complex care conditions. Although centralisation is presented as “evidence-based”, the relevant studies are often challenged by groups which hold perspectives and values beyond those implicit in the literature. This study investigated stakeholder perspectives on the rationale for the reconfiguration of urgent and emergency care in Ireland. Specifically, it considered the hypothesis that individuals from different stakeholder groups would endorse different positions in relation to the motivation for, and goals of, reconfiguration. Methods Documentary analysis of policy documents was used to identify official justifications for change. Semi-structured interviews with 175 purposively sampled stakeholders explored their perspectives on the rationale for reconfiguration. Results While there was some within-group variation, internal and external stakeholders generally vocalised different lines of argument. Clinicians and management in the internal stakeholder group proposed arguments in favour of reconfiguration based on efficiency and safety claims. External stakeholders, including hospital campaigners and local political representatives expressed arguments that focused on access to care. A “voter” argument, focused on the role of local politicians in determining the outcome of reconfiguration planning, was mentioned by both internal and external stakeholders, often in a critical fashion. Conclusion Our study adds to an emerging literature on the interaction between a technocratic approach to health system planning advocated by clinicians and health service managers, and the experiential “non-expert” claims of the public and patients.
وصف الملف: application/pdf
تدمد: 1099-1751
0749-6753
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::50a568fbf59e2ed21d2cfe12d25117f7
https://doi.org/10.1002/hpm.2469
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....50a568fbf59e2ed21d2cfe12d25117f7
قاعدة البيانات: OpenAIRE