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大規模な改革から2年後の保健・社会サービスシステムのガバナンス: フィンランドにおける質的研究
Satu Paatela1, Moona Huhtakangas2, Liina-Kaisa Tynkkynen1
1The Welfare State Research Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Journal of health organization and management
|September 3, 2025
まとめ
フィンランド
科学分野:
- 公衆衛生政策
- 医療システムのガバナンス
- 社会サービス局
背景:
- フィンランドは2023年に大規模な構造改革を行い,公衆衛生と社会サービスを再編成しました.
- この改革は,システムガバナンスに影響を与える,行政と金融の構造を集中させることを目的とした.
- 治理は医療システムにおける重要な機能として認識されています.
研究 の 目的:
- フィンランドの2023年保健・社会サービス改革に伴うガバナンス構造の具体的な変化について説明する.
- 公共衛生と社会サービス提供に対する行政・財政再編の影響を分析する.
- 主要なガバナンス課題と改革から得た教訓を特定する.
主な方法:
- 福祉サービス郡 (WBSC) のディレクター (n=38) と省の代表 (n=8) との半構造面接が行われました.
- データ収集は2023年から2024年の2つの時点で行われました.
- インタビューデータを分析するために,誘導的なテーマ分析が採用されました.
主要な成果:
- 改革により,サービス組織の責任は自治体からWBSCに移され,資金は州レベルで集中されました.
- 権力のバランスと役割の定義は 統治レベルで大きく変化した.
- 国内政策の目標と自治体の能力の限界の間の競争の出現が観察されました.
結論:
- フィンランドの改革は,世界的に保健システムのガバナンスを再編するための貴重な洞察を提供します.
- この研究は,医療制度改革におけるガバナンスが果たす重要な役割を強調しています.
- 保健医療と社会サービスにおける役割の再分配において,責任と委任の明確さは極めて重要です.
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