The Influence of a Policy Document in the Practice of Intersectorial Collaboration in Danish Health Care: A critical discourse analysis

Background
Policy documents are powerful actors in health care, and they play a significant role because they produce certain discursive and non-discursive conditions for intersectorial collaboration.
Central documents in Denmark are the Health Agreements. These policy documents set out the premises for collaboration between hospitals, municipalities, and general practitioners in the five regions. This area is traditionally contested, and the intention of the Health Agreements is to be a guideline for the allocation of tasks and responsibilities within the collaboration.
Aim
• To exemplify and discuss how linguistic features and wordings in the Health Agreement for Central Denmark Region produce a certain understanding of intersectorial collaboration the health care system.
• To show how a critical discourse analysis (CDA) can give health care providers and researchers a tool to critically assess a policy document.
Method
A critical discourse analysis based on a three-dimensional model.
Findings
Our analysis showed how wordings and grammatical features create and maintain certain perceptions or common-sense understandings of actors, responsibilities, and tasks in health care.
The linguistic analysis of grammatical features present in the document enabled us to demonstrate how the authors of Health Agreements apply governing technologies to control the delivery of intersectorial health care in Denmark.
Furthermore, the findings showed how this policy document, through its use of language, constructs the actors in intersectorial collaboration within the framework of a market-economy understanding, the goal being to increase productivity and efficiency in health care delivery.