The States and Health Care Reform: The Road Traveled and Lessons Learned from Seven That Took the Lead

Paul-Shaheen, Pamela

doi:10.1215/03616878-23-2-319

Cited by 28 publications

(23 citation statements)

References 19 publications

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“…In the organizational field, very few studies are concerned with the process of implementing collaboration among organizations while studies on strategic change and inter-organizational relationships or networks are plentiful (Whipp et al, 1989;Ferlie and Bennett, 1992;Paul-Shahenn, 1998;Manley, 2000). Researches in this corpus are frequently decontextualized, and are not often based on qualitative inquiries (Oliver and Ebers, 1998).…”

Section: Analytic Model Of Pros Implementation and Of Its Impact On Nmentioning

confidence: 99%

Regional planning implementation and its impact on integration of a mental health care network

Fleury¹,

Mercier²,

Denis³

2002

Health Planning & Management

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This article questions the effectiveness of a managerial tool in changing a health-care system. The process of implementing regional planning and its impact on creating integrated service networks is examined, using a case study and a multi-dimensional analytic model. This model highlights the influence of contextual, structural, cultural and dynamic factors on forming networks. The regional planning developed in the province of Québec (Canada), aimed at a major transformation of the mental health-care system. In each district, organizations working with people who have serious mental disorders were mobilized to plan and implement a more coordinated, continuous and diversified supply of services, under the direction of a regional health body. This study outlines the limitations of regional planning as a tactic for transforming the system. It recommends instead developing more diversified integration strategies to further the process of forming integrated service networks within a complex system. In conclusion, a brief discussion deals with the difficulties related to the study of systemic change implementation.

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Section: Analytic Model Of Pros Implementation and Of Its Impact On Nmentioning

confidence: 99%

Regional planning implementation and its impact on integration of a mental health care network

Fleury¹,

Mercier²,

Denis³

2002

Health Planning & Management

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“…Vermont has consistently been one of a handful of states that has "taken the lead" in health reform [38]. Since the 1970s, Vermont has made progressive improvements to its health systemincreasing coverage, improving coordination, and attempting to control costs.…”

Section: Constraint: Stakeholder Analysismentioning

confidence: 99%

State-Based Single-Payer Health Care — A Solution for the United States?

Hsiao¹

2011

N Engl J Med

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ii ACKNOWLEDGEMENTSWe would like to thank the more than 100 individuals who met or talked with us over the course of this study, sharing their views, ideas and insights on health reform in Vermont. Without their contributions, our work would not have been possible. _________We would also like to thank the numerous Vermonters and Vermont organizations who provided thoughtful comments and insight during the public comment period. Their efforts helped make this report better, clearer and hopefully more useful to the State of Vermont.The comments pointed out some gaps, lack of clarity and inadequate analysis in our draft report. We are deeply grateful for these comments and have revised our draft report to improve the completeness and clarity of our analysis. The comments painted a clear picture of the diversity of views, of experiences with the health care system, of the deep feelings and beliefs about what a health care system should be, and the desire to do better for Vermonters. The comments also showed a sense of trepidation at the prospect of major systemic change, despite a general agreement over the unacceptability of the status quo.Health care touches us all, in personal, professional and economic ways. Major change brings uncertainties. We strongly believe, however, that Vermont can achieve its goals and set a model for the nation for an equitable, affordable, high-performing health system. _________ iii DISCLAIMERWe would like to thank the many institutions and organizations that allowed us to use their data to conduct analyses vital to this report. Unless otherwise cited from a published report, the analyses and the responsibility for their accuracy and integrity are solely ours. Any conclusions and recommendations in this report are solely those of Dr. Hsiao and are not necessarily those of the institutions and organizations that provided data.

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“…However there were two examples of civil society influence, albeit weak, on the reform processes. The media, which can play an important role in communication between the public and government (Walt, 1994;Paul-Shaheen, 1998; Alliance for Health Policy and Systems Research, 2007) was initially passive, but became active covering the debate between the government and one of the newspaper groups about granting autonomy to the medical institutions.…”

Section: Role Of the Policy Actorsmentioning

confidence: 99%

Policy process for health sector reforms: a case study of Punjab Province (Pakistan)

Tarin

Green

Omar

et al. 2009

Health Planning & Management

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The health sector in the Punjab (Pakistan) faces many problems, and, the government introduced reforms during 1993-2000. This paper explores the policy process for the reforms. A case study method was used and, to assist this, a conceptual framework was developed. Analysis of four initiatives indicated that there were deviations from the government guidelines and that the policy processes used were weak. The progress of different reforms was affected by a variety of factors: the immaturity of the political process and civil society, which together with innate conservatism and resistance to change on the part of the bureaucracy resulted in weak strategic sectoral leadership and a lack of clear purpose underpinning the reforms. It also resulted in weaknesses in preparation of the detail of reforms leading to poor implementation. The study suggests a need for broadening the stakeholders' base, building the capacity of policy-makers in policy analysis and strengthening the institutional basis of policymaking bodies.

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The States and Health Care Reform: The Road Traveled and Lessons Learned from Seven That Took the Lead

Cited by 28 publications

References 19 publications

Regional planning implementation and its impact on integration of a mental health care network

Regional planning implementation and its impact on integration of a mental health care network

State-Based Single-Payer Health Care — A Solution for the United States?

Policy process for health sector reforms: a case study of Punjab Province (Pakistan)

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