University of Suffolk, Ipswich, UK.
University of Lincoln, Lincoln, UK.
Int J Health Policy Manag. 2018 Apr 1;7(4):359-361. doi: 10.15171/ijhpm.2017.100.
This paper offers a short commentary on the editorial by Mannion and Exworthy. The paper highlights the positive insights offered by their analysis into the tensions between the competing institutional logics of standardization and customization in healthcare, in part manifested in the conflict between managers and professionals, and endorses the plea of the authors for further research in this field. However, the editorial is criticized for its lack of a strong societal reference point, the comparative absence of focus on hybridization, and its failure to highlight structural factors impinging on the opposing logics in a broader neo-institutional framework. With reference to the Procrustean metaphor, it is argued that greater stress should be placed on the healthcare user in future health policy. Finally, the case of complementary and alternative medicine is set out which - while not explicitly mentioned in the editorial - most effectively concretizes the tensions at the heart of this analysis of healthcare.
本文对曼尼恩和埃克斯沃西的社论进行了简短的评论。本文强调了他们的分析为我们提供的积极见解，即标准化和定制化这两种相互竞争的医疗机构逻辑之间存在紧张关系，部分表现为管理者和专业人员之间的冲突，并赞同作者在该领域进一步研究的呼吁。然而，这篇社论也受到了批评，批评意见主要包括：缺乏强有力的社会参照点、对混合的关注相对较少，以及未能在更广泛的新制度框架内突出影响对立逻辑的结构性因素。本文借用普罗克汝斯忒斯之床的比喻，认为未来的卫生政策应该更加重视医疗保健用户。最后，本文还阐述了补充和替代医学的案例，虽然该案例在社论中并未明确提及，但最有效地具体说明了这一医疗分析核心的紧张关系。
