超过眼睛所能看到的:对瑞典卫生系统改革的批判性话语分析
Frida Jonsson1,2, Hanna Blåhed3,4, Anna-Karin Hurtig3
1Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden. frida.jonsson@umu.se.
BMC health services research
|November 10, 2023
概括
瑞典的卫生改革,专注于初级医疗保健 (PHC),可能会忽视诸如健康促进和公平获取等关键方面,因为问题在政府报告中是如何构成的.
科学领域:
- 卫生政策分析 卫生政策分析
- 公共卫生系统研究 公共卫生系统研究
- 医疗保健中的话语分析
背景情况:
- 全球强调初级医疗保健 (PHC) 为人口健康和公平.
- 瑞典卫生系统改革优先考虑医疗保健原则.
- 对瑞典的医疗保健改革进行了有限的话语分析.
研究的目的:
- 分析瑞典政府报告中关于卫生系统重定向的表述.
- 探索"优质和当地的医疗保健"是如何构成的.
- 识别政策话语中的潜在沉默.
主要方法:
- 对瑞典政府四份官方报告的政策作为话语分析.
- 应用巴基的"问题是什么?"的应用. (WPR) 的方法.
- 问题表示的识别,分析和主题化.
主要成果:
- 确定了三个问题表示:狭窄的任务,孤立的结构,断开的前线服务.
- 政策制定可能会使公共卫生和医疗保健的关键要素保持沉默:健康促进,公平,人力资源.
- 话语框架忽视了患者的需求和偏好.
结论:
- 瑞典政府的报告以忽视中央PHC方面的方式对卫生系统问题进行了框架.
- 承认这些言论性沉默对于有效的卫生系统重定位至关重要.
- 目前的框架可能会阻碍发展一个公平和可访问的PHC系统.
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