Analysing boundaries of health and social care in policy and media reform narratives

被引:5
作者
van Duijn, Sarah [1 ]
Bannink, Duco [1 ]
Nies, Henk [1 ,2 ]
机构
[1] Vrije Univ Amsterdam, Amsterdam, Netherlands
[2] Vilans, Ctr Expertise Long Term Care, Utrecht, Netherlands
来源
POLICY AND POLITICS | 2022年 / 50卷 / 04期
关键词
boundary work; critical discourse analysis; healthcare reform; media framing; collaboration; Netherlands; policy design; policy implementation; WORK; GOVERNANCE; ORGANIZATIONS; CONSTRUCTION; ATTENTION; INTERPLAY; FIELD;
D O I
10.1332/030557321X16420783121324
中图分类号
D0 [政治学、政治理论];
学科分类号
0302 ; 030201 ;
摘要
Collaboration has become an imperative of many new healthcare policies; however, little attention has been paid to how system-level narratives in both policy documents and the media create boundaries that shape implementation processes. By using boundary work as a theoretical lens, this article critically analyses the discourse found in both policy documents and the media surrounding the 2015 Dutch LTC reform. This discourse analysis contributes, first, by revealing two separate narratives - one epic, one tragic - which we argue represent different rhetorical styles used to (de-) legitimise symbolic boundaries. Second, we contribute by unravelling boundary work in both the social and symbolic dimensions to show how the design of the 2015 reform led to a tension-ridden position for local actors: symbolic boundaries demanded integration, while social boundaries imposed differentiation. These findings have implications for literature on boundary work as well as for policy design and its local implementation.
引用
收藏
页码:568 / 586
页数:19
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