RESUMEN
This paper explores and compares health system responses to the COVID-19 pandemic in Denmark, Finland, Iceland, Norway and Sweden, in the context of existing governance features. Content compiled in the Covid-19 Health System Response Monitor combined with other publicly available country information serve as the foundation for this analysis. The analysis mainly covers early response until August 2020, but includes some key policy and epidemiological developments up until December 2020. Our findings suggest that despite the many similarities in adopted policy measures, the five countries display differences in implementation as well as outcomes. Declaration of state of emergency has differed in the Nordic region, whereas the emphasis on specialist advisory agencies in the decision-making process is a common feature. There may be differences in how respective populations complied with the recommended measures, and we suggest that other structural and circumstantial factors may have an important role in variations in outcomes across the Nordic countries. The high incidence rates among migrant populations and temporary migrant workers, as well as differences in working conditions are important factors to explore further. An important question for future research is how the COVID-19 epidemic will influence legislation and key principles of governance in the Nordic countries.
Asunto(s)
COVID-19 , Pandemias , Dinamarca , Finlandia , Humanos , Islandia/epidemiología , Incidencia , Noruega , Políticas , Países Escandinavos y Nórdicos/epidemiología , SueciaRESUMEN
Bundled payments were introduced in the Norwegian health service in 2019. This article examines the historical background and knowledge base relating to this payment model, whose use is steadily increasing in the United States and throughout Europe.
Asunto(s)
Paquetes de Atención al Paciente , Humanos , Mecanismo de Reembolso , Estados UnidosRESUMEN
PURPOSE: This paper aims to discuss recent contributions to comparative healthcare systems research, which emphasise decentralisation as a major characteristic of Scandinavian hospital systems. Whether the idea of such a "decentralised Scandinavian model" is appropriate and useful, how and why it was created, and what the alternative is, are central questions approached through a perspective gathered from historical institutionalism. DESIGN/METHODOLOGY/APPROACH: The paper employs an analysis of primary and secondary sources on the history of Scandinavian hospital systems, a classification based on historical developments, and an explanatory framework based on historical institutionalism. FINDINGS: The paper concludes that the idea of a decentralised Scandinavian model for hospital systems has had limited validity, constrained to the years 1970-2000. Historical trajectories and recent developments both indicate that the three systems are more different than commonly assumed, and that recently they seem to be moving in separate directions. The explanation for the developments is found in incremental dynamics, creating institutional change that to a large extent depends on national contexts. ORIGINALITY/VALUE: The paper contributes to the current discussion and research relating to classification of health care systems, and aims at developing a more elaborate understanding of the role of the hospital sectors within the Scandinavian welfare states. It challenges the idea that a single model can capture the essence of such diverse systems, and proposes an alternative to such modelling, based on a historical-institutional approach.