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Effekt av ADL - trening for personer med kronisk obstruktiv lungesykdom - en randomisert kontrollert studie
Engelsk titel: Effect of ADL - training of persons with chronic obstructive lung disease - a randomized controlled trial Läs online Författare: Hansen, Frederik Bjørge ; Mengshoel, Anne Marit Språk: Nor Antal referenser: 34 Dokumenttyp: RCT UI-nummer: 11083264

Tidskrift

Ergoterapeuten (Oslo) 2011;54(3)38-46 ISSN 0800-3475 KIBs bestånd av denna tidskrift Denna tidskrift är expertgranskad (Peer-Reviewed)

Sammanfattning

The Purchaser-Provider Model is on its way into Norwegian municipalities. The model assumes a separation of the roles of purchaser and provider, and that these roles are carried out through different organisational units. This paper addresses the implementation of the purchaser-provider model in physiotherapy and occupational therapy services in a local district in the city of Oslo. The empirical material consists of interviews with the persons responsible for both purchasing and providing the physiotherapy and occupational therapy services in the district, and in addition various relevant documents. The practice in the district represents a significant modification of the theoretical «ideal» model. The model is implemented internally in the municipal organisation, the provider has the budgetary responsibility, it is a close integration between purchaser and provider, and the roles are not distinctly separated. The basis for this adjustment can be understood within three contexts. Firstly, a local context related to the implementation of the model in the district. Secondly, the context related to the professional field of rehabilitation, and thirdly, a Norwegian municipal context. The discussion shows the importance of studying implementation of such models in a contextual perspective. Further, the results give reasons to bring up an issue concerning the connection between organisational modernisation in the municipalities and the effects on the quality of services.