Governing citizens and health professionals at a distance: A critical discourse analysis of policies of intersectorial collaboration in Danish health-care

Anne Bendix Andersen, Kirsten Frederiksen, Raymond Kolbæk, Kirsten Beedholm

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

It is widely recognised that the delivery of services across health-care sectors faces multiple challenges related to incoherence in patient pathways. There are multiple reasons for this incoherence, which are often dealt with through national legislation and policy-making. This paper discusses policies as powerful actors and explores how effects of a concrete policy are adapted for intersectorial collaboration in Danish healthcare. The paper is based on a critical discourse analysis of a central policy document in Danish health-care known as the ‘Health Agreements’. Using Fairclough’s three-dimensional model for discourse analysis, we explored the document to clarify the construction of actors participating in intersectorial collaboration. The analysis revealed the Health Agreement as a ‘negotiated text’, appearing as an overriding document legitimising one possible discourse regarding the premises of intersectorial collaboration.
The premises of intersectorial collaboration are maintained through a specific presentation of actors leaving little room for discussion, where professionals are constructed as actors who are expected to develop ways of collaborating according to the Triple Aim approach in order to promote productivity and efficiency. Furthermore, this presentation constructs citizens and patients as active, participating individuals who consciously prioritise and act with the purpose of controlling their life situation.
Original languageEnglish
JournalNursing Inquiry
Volume24
Issue number4
Number of pages9
ISSN1320-7881
DOIs
Publication statusPublished - 29 Oct 2017

Keywords

  • health, nutrition and quality of life
  • care integration
  • care pathways
  • discourse
  • health policy

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