Kampen om færdigbehandling

Abstract

The classification of a patient as ‘treatment completed’ indicates that the transfer of costs for the hospitalization to the municipality. Accordingly, ‘treatment completed’ is a central concept in the financial settlement between the municipality and the hospital. This thesis highlights the construction and definition of ‘treatment completed’, and how value is created for the patient in the transition from hospital to the municipal rehabilitation-unit. Additionally, this study will clarify the points of conflicts regarding the actual status as ‘treatment completed’ of a patient. Finally, the managerial related implications will be described. The Actor-network theory (ANT) is applied as the analytical tool and the study is designed as a case-study in a municipal unit. The result show that ‘treatment completed’ is used in several versions, i.e. one hospital version (a technical treatment completed), one version used by the municipal care-system and one version used by the patient. Furthermore, the analysis illustrates patient navigation between the different versions. The study showsthe major elementsinfluencing the construction process of ‘treatment completed’ is control elements such as economy, time and capacity. The term ‘treatment completed’ is a powerful steering tool and is accepted as such by the municipal nurses who, in collaboration with the hospital nurses, form a professional alliance in negotiation the patient is ‘treatment completed’. It is concluded that if the value for the patients is to be improved the relation between actants and actors needsto be strengthen. Furthermore, it is concluded that the ‘treatment completed’ is an integral part of the public service/governmentalstruggles of resources and the negotiation takes into account the efficiency of the capacity in each sector.