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政策过程在卫生服务重构中的作用:证据、路径依赖与框架——评“英国医疗体系重大变革中‘关注历史’:专科癌症手术服务重构”

The Role of the Policy Process on Health Service Reconfigurations: Evidence, Path Dependency and Framing Comment on "'Attending to History' in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration".

机构信息

King's College London, London, UK.

出版信息

Int J Health Policy Manag. 2023;12:7642. doi: 10.34172/ijhpm.2022.7642. Epub 2022 Nov 20.

Abstract

Historically healthcare services have largely developed on an incremental basis, with various piecemeal changes and some notable policy leaps that illustrate a punctuated equilibrium health policy process. More recently policy-makers have attempted, successfully and unsuccessfully, to reconfigure healthcare services to address perceived problems in the delivery of important services such as stroke, cancer, and trauma. Perry et al provide a welcome addition to research in this area by focusing on the importance of history in a reconfiguration of cancer services in Greater Manchester (GM). Perry et al analyse how and why this configuration was successful after several failed attempts in the past and in this commentary, I want to reflect on the explanatory role health policy analysis can contribute to studying the reconfiguration of healthcare services.

摘要

从历史上看,医疗保健服务主要是在增量的基础上发展起来的,有各种零碎的变化和一些显著的政策飞跃,说明了间断平衡的卫生政策过程。最近,政策制定者试图(成功和不成功地)重新配置医疗保健服务,以解决在提供重要服务(如中风、癌症和创伤)方面存在的问题。佩里等人通过关注大曼彻斯特(GM)癌症服务重新配置中的历史重要性,为该领域的研究做出了可喜的贡献。佩里等人分析了在过去几次失败尝试之后,这种配置是如何以及为何成功的,在这篇评论中,我想思考卫生政策分析在研究医疗保健服务重新配置方面所能做出的解释作用。

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