Over the past decade, there has been a shift in the municipal care service responsibilities, tasks, focuses and ways of organization creating a new care service landscape in Norway. The municipalities have considerable autonomy in designing and governing their care services leading to heterogeneous care service models throughout the country. In order to develop health care services within budget limits, municipal leaders and local politicians are facing tough priorities. The PriCare-project will produce novel insight into the (re)design of Norwegian municipal care services by exploring the emerging care service landscape through a focus on the inherent processes of prioritization and dilemmas and the effect of these processes on the entire care service chain. We analyse prioritization at four nodes of the care service chain: provision (which services are provided and under what conditions), distribution (how users obtain access to different services), delivery (the norms that shape the relationship between health professionals and users) and governance (how practices are evaluated, maintained or transformed). The empirical analyses will build on a combination of data sources including register data, a survey among a representative selection of municipalities, white and green papers, and a case study in a selection of municipalities representing different care service models. In the case study, we draw on fieldwork, document analysis and interviews with municipal managers, politicians, healthcare professionals, and users as well as their next of kind. The results will contribute to discuss the significance of the changes in the care services in relation to basic values of the Norwegian welfare state, including justice, equality and universal access. PriCare’s overall ambitions are to build theoretical approaches and appropriate methodology suitable for a continuous analysis of service trends in the municipal care service landscape, as well as to gain new knowledge of significant factors shaping municipal prioritization. Finally, in PriCare we have planned for, and will ensure, user involvement throughout all phases and parts of the project.
Finansieringskilde: Norges Forskningsråd
Prosjektleder Ragnhild Hellesø