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Pursuing collaborative advantage in Swedish care for older people: stakeholders' views on trust

Journal article
Authors Inger Kjellberg
Stefan Szücs
Published in Journal of Integrated Care
ISSN 1476-9018
Publication year 2020
Published at Department of Social Work
Language en
Links https://doi.org/10.1108/JICA-01-202...
Keywords Integration, Older people, Health and social care, Policy implementation
Subject categories Social welfare/social pedagogics, Older people and ageing

Abstract

Purpose The purpose of this paper is to explore stakeholder views on the policy of integrated health and social care for older people with complex needs in Sweden and the issue of trust in implementing the policy. Design/methodology/approach The study used a qualitative interview design and interviews with nine strategically selected stakeholders. A thematic analysis focused on trust, as defined in the theory of collaborative advantage, was used. Findings This study of health and social care exposed a lack of trust on political, strategic and inter-professional levels. Two opposing lines of argument were identified in the interviews. One advocated a single government authority for health and social care. The other was in accordance with recently implemented national policies, which entailed more collaboration between local government authorities, obliging them to make joint local agreements. The Swedish experience is discussed in an international context, examining the need for collaboration in integrated care services for older people. Research limitations/implications Although the findings are important for the current adjustment in health and social care for older people, the number of interviewees are limited. Future studies will include more regions and longitudinal studies. Originality/value Sweden is currently undergoing an extensive adjustment in line with recent national government policy which involves more primary health care and a corresponding reduction in the number of hospital beds. The restructuring of the care system for older people with complex needs is a paradox, as it simultaneously increases the need for centralisation while also increasing coordination and collaboration on a local basis.

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