Comparative Perspectives and Policy Learning in the World of Health Care

Marmor, Theodore R.; Freeman, Richard; Okma, Kieke G. H.

doi:10.1080/13876980500319253

Cited by 120 publications

(95 citation statements)

References 26 publications

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“…Marmor et al 109 distinguish three principal purposes of comparative analysis in health policy: (1) learning about national health systems and polices, (2) learning why they take the forms they do and (3) learning from other countries for potential application of policies elsewhere. The first seeks to explore systems and policies in different countries without necessarily aiming at a causal explanation of observed phenomena or seeking the transfer of policies.…”

Section: Methodsmentioning

confidence: 99%

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Pitchforth

Nolte

Corbett

et al. 2017

Health Serv Deliv Res

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BackgroundThe notion of a community hospital in England is evolving from the traditional model of a local hospital staffed by general practitioners and nurses and serving mainly rural populations. Along with the diversification of models, there is a renewed policy interest in community hospitals and their potential to deliver integrated care. However, there is a need to better understand the role of different models of community hospitals within the wider health economy and an opportunity to learn from experiences of other countries to inform this potential.ObjectivesThis study sought to (1) define the nature and scope of service provision models that fit under the umbrella term ‘community hospital’ in the UK and other high-income countries, (2) analyse evidence of their effectiveness and efficiency, (3) explore the wider role and impact of community engagement in community hospitals, (4) understand how models in other countries operate and asses their role within the wider health-care system, and (5) identify the potential for community hospitals to perform an integrative role in the delivery of health and social care.MethodsA multimethod study including a scoping review of community hospital models, a linked systematic review of their effectiveness and efficiency, an analysis of experiences in Australia, Finland, Italy, Norway and Scotland, and case studies of four community hospitals in Finland, Italy and Scotland.ResultsThe evidence reviews found that community hospitals provide a diverse range of services, spanning primary, secondary and long-term care in geographical and health system contexts. They can offer an effective and efficient alternative to acute hospitals. Patient experience was frequently reported to be better at community hospitals, and the cost-effectiveness of some models was found to be similar to that of general hospitals, although evidence was limited. Evidence from other countries showed that community hospitals provide a wide spectrum of health services that lie on a continuum between serving a ‘geographic purpose’ and having a specific population focus, mainly older people. Structures continue to evolve as countries embark on major reforms to integrate health and social care. Case studies highlighted that it is important to consider local and national contexts when looking at how to transfer models across settings, how to overcome barriers to integration beyond location and how the community should be best represented.LimitationsThe use of a restricted definition may have excluded some relevant community hospital models, and the small number of countries and case studies included for comparison may limit the transferability of findings for England. Although this research provides detailed insights into community hospitals in five countries, it was not in its scope to include the perspective of patients in any depth.ConclusionsAt a time when emphasis is being placed on integrated and community-based care, community hospitals have the potential to assume a more strategic role in health-care delivery locally, providing care closer to people’s homes. There is a need for more research into the effectiveness and cost-effectiveness of community hospitals, the role of the community and optimal staff profile(s).FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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Section: Methodsmentioning

confidence: 99%

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Pitchforth

Nolte

Corbett

et al. 2017

Health Serv Deliv Res

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“…These national variations can be attributed to differences in institutional context and the distribution of power. Reforms with a common international dimension are shaped by national institutions, social and cultural systems (Marmor et al 2005 ). The centralist tradition of the French healthcare system resulted in a very hierarchical approach to implementation of privatisation-oriented reforms (Couty 2010 ), whereas in Germany the traditional decentralised, multi-body structure of hospital governance has proven to be an obstacle to implementing solutions consistently across the nation.…”

Section: Explaining the Developmentsmentioning

confidence: 99%

Local Public Services in Italy: Still Fragmentation

Citroni

Lippi

Profeti

2016

Public and Social Services in Europe

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“…They regularly use cross-national information as 'warfare ammunition' for policies that they support on other grounds. 2 There has been rapid growth of 'health policy tourism' to study policy experiences abroad. For example, several delegations of European experts visited California's Kaiser Permanente (KP) in the last few years, as they saw KP as the ultimate role model for 'integrated care' .…”

Section: World-class Commissioning: •mentioning

confidence: 99%

“…What are the ground rules that make sense to apply? 2 The second section discusses four major causes of confusion, particularly the lack of generally agreed vocabulary to describe the issues at hand. We illustrate this with some widely used labels and terms in comparative policy studies.…”

Section: Introductionmentioning

confidence: 99%

Comparative studies and healthcare policy: learning and mislearning across borders

Okma

Marmor

2013

Clinical Medicine

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-This article addresses the vocabulary of crossnational analysis and commentary about health care, health policy and health politics. We conclude there is a large gap between promise and performance in comparative policy commentary and point to major sources of confusion, such as the lack of generally agreed vocabulary, vague language and the use of faddish and misleading terms and aspirational labels (illustrated by a selection of widely used expressions in comparative reports). We next examine the basic purposes of international policy comparison, distinguish three useful and two misleading approaches and frame defensible ground rules for comparative work.KEY WORDS: Comparative policy analysis, international comparison, healthcare, health policy, health politics, policy learning and mislearning, faddish vocabulary, misleading language

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Comparative Perspectives and Policy Learning in the World of Health Care

Cited by 120 publications

References 26 publications

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Community hospitals and their services in the NHS: identifying transferable learning from international developments – scoping review, systematic review, country reports and case studies

Local Public Services in Italy: Still Fragmentation

Comparative studies and healthcare policy: learning and mislearning across borders

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