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Reforming medical governance in Europe. What is it about institutions?

Published online by Cambridge University Press:  01 July 2009

VIOLA BURAU ,
DAVID WILSFORD  and
GEORGE FRANCE
VIOLA BURAU*
Affiliation:
Associate Professor, Department of Political Science, University of Aarhus, Aarhus C, Denmark
DAVID WILSFORD
Affiliation:
Professor, Department of Public and International Affairs, George Mason University, Fairfax, VA, USA
GEORGE FRANCE
Affiliation:
Research Associate, Institute for the Study of Regionalism, Federalism and Self-government, Rome, Italy
*
*Correspondence to: Viola Burau, Associate Professor, Department of Political Science, University of Aarhus, Bartholins Allé, DK-8000 Aarhus C, Denmark. Email: viola@ps.au.dk
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Abstract

This article presents a cross-national analytical framework for understanding current attempts to reform medical governance – in particular, those by third parties to control the practice of medicine. The framework pays particular attention to the ways in which institutions shape policy reform. The article also outlines the main comparative findings of case studies of selected reforms and associated processes of negotiations in Denmark, Germany, Italy and the United Kingdom. These four countries were selected because they are characterised by theoretically interesting variations in the institutional contexts of medical governance. The analysis suggests that although all the four countries have pushed for more control over the way in which doctors practise medicine, in response to similar imperatives, each country differs in the path it has taken. More specifically, the instruments and techniques brought to bear in each case vary considerably and are directed by a country's political institutions towards a unique path.

Type
Articles
Information
Health Economics, Policy and Law , Volume 4 , Issue 3: Governing Medical Performance: A Comparative Analysis of Pathways of Change , July 2009 , pp. 265 - 281
Copyright
Copyright © Cambridge University Press 2009

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