Fredriksson Mio, Moberg Linda
Department of Public Health and Caring Sciences, Uppsala Universitet , Uppsala, Sweden.
J Health Organ Manag. 2018 Nov 19;32(8):943-961. doi: 10.1108/JHOM-08-2018-0219. Epub 2018 Nov 6.
The purpose of this paper was to study the unfolding of an urgent and extensive decommissioning program in Sweden, focusing on the public's reactions and their arguments when opposing the decommissioning activities.
DESIGN/METHODOLOGY/APPROACH: The public's responses were studied through local media. Its content was surveyed and divided into actions and arguments. The arguments were further analyzed and categorized into inductively developed themes.
Protest activities, such as demonstrations, meetings and petitions, were not coordinated, but mostly carried out for withdrawals of unique services and services in remote areas. The public questioned the decision makers' information, calculations and competence, the adequacy of the consequence analyses and whether the decommissioning activities would lead to any real savings. Patient and public safety, the vulnerable in society, and effects on the local areas were important topics. Thus, it seems the decision makers did not fully succeed in communicating the demonstrable benefits or create clarity of the rationales for decommissioning the particular services. Furthermore, it seems the public has a more inclusive approach to health services and their value compared to decision makers that need to keep the budget.
ORIGINALITY/VALUE: Decommissioning is an emerging field of research, and this study of the unfolding of an urgent and extensive decommissioning program contributes with evidence that may improve decommissioning policy and practice. The study illustrates that it may be possible to implement a decommissioning program despite public protest, but that the longer-term effects on the health system's legitimacy need to be studied.
本文旨在研究瑞典一项紧急且广泛的退役计划的展开情况，重点关注公众在反对退役活动时的反应及其论据。
设计/方法/途径：通过当地媒体研究公众的反应。对其内容进行调查并分为行动和论据。进一步分析论据并归纳为不同的主题。
抗议活动，如示威、会议和请愿，并未得到协调，主要是针对独特服务的撤销以及偏远地区服务的撤销而开展。公众质疑决策者的信息、计算和能力，后果分析的充分性以及退役活动是否会带来实际节省。患者和公众安全、社会中的弱势群体以及对当地地区的影响是重要话题。因此，决策者似乎未能充分成功地传达可证明的益处，也未能阐明退役特定服务的理由。此外，与需要控制预算的决策者相比，公众对医疗服务及其价值的看法似乎更为包容。
原创性/价值：退役是一个新兴的研究领域，对这一紧急且广泛的退役计划展开情况的研究提供了证据，可能有助于改进退役政策和实践。该研究表明，尽管有公众抗议，实施退役计划仍有可能，但对卫生系统合法性的长期影响需要进行研究。
