Implementing Change in Health Systems brings fresh thinking and evidence to the continuing debate about market reforms of health care and other public services. The book examines the development and implementation of national cost-containment programs and health system reorganizations in the UK, Sweden and the Netherlands ― countries that have been leaders in health system reform.
The book provides a new framework for analyzing public policy implementation and system change, synthesizing diverse streams of academic research and thinking. It explores the processes of implementing market reforms in each country and considers the outcomes, both expected and unintended. In all three countries competitive reform encountered serious technical, organizational and political obstacles. Yet they triggered important system changes and paved the way for significant new health policies.
The complex outcomes of the reforms included
• changes in the quality, efficiency and costs of care
• growing managerial and political control over physicians and other health care professionals
• increased influence and centrality of community-based care
• Diffusion of ideas and practices from business management into health care.
Implementing Change in Health Systems sheds new light on crucial policy issues that are currently being debated in the United States and many other countries. The book will be of value to students, researchers, and practitioners in health policy and public policy.
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Michael I. Harrison, Ph.D, is a Senior Social Scientist in the Center for Delivery, Organization, and Markets at the Agency for Healthcare Research and Quality (AHRQ). He leads Agency activities in Health System Design, manages and contributes to research in delivery systems across the United States, and conducts research on organizational improvement and implementation of system change.
His publications include papers in leading health services research journals, Diagnosing Organizations: Methods, Models, and Processes (Sage, 2005), and Implementing Change in Health Systems: Market Reforms in the United Kingdom, Sweden, and the Netherlands (SAGE, 2004). He has given presentations and led workshops at scientific and professional conferences throughout the United States and Europe.Dr. Harrison holds a Ph.D. in Sociology from the University of Michigan. He was previously a faculty member at the State University of New York (SUNY), Stony Brook, and at Bar Ilan University in Israel; a visiting professor at Boston College and Haifa University; and a visiting scholar at Brandeis University, Georgetown University, Harvard Business School, and the Nordic School of Public Health.
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