Suchergebnisse

"'Knowledge is the currency of competition.' (Abbott 1988) Diese These der Professionssoziologie greift die Autorin auf und wendet sie auf die Modernisierungsprozesse im Gesundheitssektor an. Im Zentrum stehen neue Formen der Legitimation von Expertenwissen infolge veränderter Steuerungsmechanismen und Regulierungsinstrumente. Sie fragt, wie und von welchen Akteuren Wissen verhandelt wird, wie es in die Praxis übersetzt wird und hier Machtverhältnisse strukturiert. Die politischen Versprechen einer Machtverschiebung, die mit dem Einzug von 'Expertenpatienten ' und 'wissenschaftlich-bürokratischer Medizin' in die Gesundheitsversorgung verbunden sind, werden mit empirischen Ergebnissen konfrontiert. Die Autorin verknüpft professionssoziologische Konzepte, die Wissen als Ressource für die Kontrolle über ein Berufsfeld und Professionalität als Regulierungsmechanismus erfassen, mit Ansätzen zur sozialen Konstruktion von Wissen und Macht. Die empirische Grundlage stellen Daten aus einem laufenden Forschungsprojekt zur Modernisierung der Gesundheitsversorgung in Deutschland dar, das die Perspektive der Ärzteschaft wie auch der PatientInnen erfasst. Die Wandlungsprozesse werden auf zwei Ebenen analysiert: neue Formen der Formalisierung und Standardisierung von Wissen auf der Makroebene - Leitlinien und evidenz-basierte Medizin - und die 'informierte Entscheidungsfindung' als neue Norm der Informationsvermittlung auf der Mikroebene. Im Zentrum steht die Frage, ob die veränderten Formen der Legitimation und Distribution von Wissen die Machtasymmetrien insbesondere zwischen ExpertInnen und Laien verringern." (Textauszug)

In diesem Beitrag zu "Organisation und Profession" sollen Hinweise dazu gegeben werden, wie die Erkenntnisse der feministischen Professionssoziologie mit aktuellen Debatten in der Organisationssoziologie verknüpft werden können und welcher Erkenntnisgewinn aus einer solchen Verknüpfung resultiert. Die Debatte erfolgt anhand empirischer Studien aus Industriebetrieben, dem öffentlichen und privaten Dienstleistungsbereich und den Hochschulen sowie anhand theoretischer Überlegungen zum Organisationslernen auf der Seite der Organisationssoziologie und Untersuchungen zur Zahnmedizin auf der Seite der Professionen. Bei aller Verschiedenheit der Untersuchungsfelder, Forschungsfragen und Methoden soll der Versuch unternommen werden, die Prozesse der Geschlechterdifferenzierung unter Berücksichtigung der jeweiligen Kontexte vergleichend zu analysieren. Die Diskussionen geben Einblicke in ganz unterschiedliche Bereiche des Arbeitsmarktes und der Entwicklungen in Organisationen. In einem reflexiven Vorgehen sollen innovative Ansätze auf ihre Reichweite und Aussagekraft in anderen Untersuchungsfeldern hin betrachtet und Möglichkeiten der Weiterentwicklung diskutiert werden. (ICH).

The present study explores the situation of migrant carers in long-term care (LTC) in European Union Member States and the disruptions caused by the COVID-19 pandemic from a public health perspective. The aim is to bring LTC migrant carers into health workforce research and highlight a need for trans-sectoral and European heath workforce governance. We apply an exploratory approach based on secondary sources, document analysis and expert information. A framework comprising four major dimensions was developed for data collection and analysis: LTC system, LTC health labour market, LTC labour migration policies and specific LTC migrant carer policies during the COVID-19 crisis March to May 2020. Material from Austria, Italy, Germany, Poland and Romania was included in the study. Results suggest that undersupply of carers coupled with cash benefits and a culture of family responsibility may result in high inflows of migrant carers, who are channelled in low-level positions or the informal care sector. COVID-19 made the fragile labour market arrangements of migrant carers visible, which may create new health risks for both the individual carer and the population. Two important policy recommendations are emerging: to include LTC migrant carers more systematically in public health and health workforce research and to develop European health workforce governance which connects health system needs, health labour markets and the individual migrant carers.

In diesem Beitrag zu "Organisation und Profession" sollen Hinweise dazu gegeben werden, wie die Erkenntnisse der feministischen Professionssoziologie mit aktuellen Debatten in der Organisationssoziologie verknüpft werden können und welcher Erkenntnisgewinn aus einer solchen Verknüpfung resultiert. Die Debatte erfolgt anhand empirischer Studien aus Industriebetrieben, dem öffentlichen und privaten Dienstleistungsbereich und den Hochschulen sowie anhand theoretischer Überlegungen zum Organisationslernen auf der Seite der Organisationssoziologie und Untersuchungen zur Zahnmedizin auf der Seite der Professionen. Bei aller Verschiedenheit der Untersuchungsfelder, Forschungsfragen und Methoden soll der Versuch unternommen werden, die Prozesse der Geschlechterdifferenzierung unter Berücksichtigung der jeweiligen Kontexte vergleichend zu analysieren. Die Diskussionen geben Einblicke in ganz unterschiedliche Bereiche des Arbeitsmarktes und der Entwicklungen in Organisationen. In einem reflexiven Vorgehen sollen innovative Ansätze auf ihre Reichweite und Aussagekraft in anderen Untersuchungsfeldern hin betrachtet und Möglichkeiten der Weiterentwicklung diskutiert werden. (ICH)

A new wave of support for populist parties and movements represents a serious threat to universal healthcare coverage in traditional liberal democracies and beyond. This article aims to contribute empirical material on the relationships between healthcare governance, professions and populism. It applies an explanatory cross-country comparative approach and uses mixed methods, including micro-level data garnered from international comparative databases and documents. Denmark, England, Germany, Italy and Turkey have been selected for comparison, reflecting different types of healthcare systems and populist movements. The results reveal variety in the ways populist discourses impact in healthcare. Abundant economic resources, network-based governance, high levels of trust in healthcare providers and doctors participating as insiders in the policy process seem to work as a bulwark against populist attacks on healthcare and professional expertise. On the other hand, poorly resourced NHS systems with doctors as outsiders in the policy process and major NPM reforms together with low to medium levels of trust in healthcare providers may be fertile ground for populist discourse to flourish. Our explanatory data provide hints of correlations, which may inform further studies to investigate causality. Yet the research highlights that healthcare governance and professions matter, and brings into view capacity for counteracting populist attacks on universal healthcare and professional knowledge.

"In welchem Verhältnis stehen die Arbeitssysteme und die Fähigkeiten und Interessen der beschäftigten Wissenschaftler/innen (Arbeitskraftpotentiale) in außerhochschulischen Forschungseinrichtungen? Welche Spannungsverhältnisse zeichnen sich ab, und welchen Einfluss haben diese auf geschlechtsdifferente Karriere- und Teilhabechancen? Diese Fragen stehen im Zentrum der Untersuchung 'Karrieren und Barrieren im Wissenschaftsbetrieb: Geschlechterdifferenz als Ergebnis von Arbeitssystemen und Aushandlungsprozessen in Organisationen', die als vergleichender Fallstudienansatz in drei ausgewählten Instituten der Wissenschaftsgemeinschaft Gottfried Wilhelm Leibniz (WGL) konzipiert ist. Auf Basis einer bisher erfolgten Teilauswertung der Materialien lässt sich eine partielle Inkompatibilität der Arbeitssysteme mit den Interessen und Fähigkeiten der Wissenschaftler/innen feststellen. Die analysierten Dimensionen Karriereaspiration, Handlungsmuster und Aushandlungsmöglichkeiten weisen zwar für sich betrachtet weitgehend geschlechtsunspezifische Ausprägungen auf, dennoch ist Geschlecht keineswegs bedeutungslos. Erst im Zusammenspiel unterschiedlicher Einflussfaktoren entfaltet sich die mögliche Wirkungsmacht der Geschlechterdifferenz. Insbesondere die unzureichende Definitionsmacht der Individuen über das Verhältnis der beruflichen und der lebensweltlichen Sphären scheint nach den bisherigen Ergebnissen differenzkonstruierend zu sein, da den Strukturen des Wissenschaftssystems eine 'männlich' normierte Sichtweise eingelagert ist." (Autorenreferat)

Research on governance often assumes that governance requires combinations of hierarchical, market and network co-ordination. However, governance versatility – understood as the existence of a repertoire of different modes of coordination – is not a characteristic of all instances of governance. The aim of this paper is to offer a more thorough analysis by exploring existing levels of governance versatility and how these are influenced by institutional profiles. Our comparative study of primary care performance across six jurisdictions suggests that higher levels of governance versatility can be shaped by very different institutional profiles. Our analysis raises important questions for future studies of governance versatility.

Background Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité – Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). Case The percentage of female medical students and doctors in all four countries is now well within the 40–60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top- level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Conclusion Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises and newly created ...

Background: Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité – Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). Case:The percentage of female medical students and doctors in all four countries is now well within the 40–60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Conclusion: Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises and newly created management structures. Developing comprehensive gender-sensitive health workforce monitoring systems and comparing progress across academic health centres in Europe could help to identify the gender leadership gap and utilise health human resources more effectively.

Background Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité – Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). Case The percentage of female medical students and doctors in all four countries is now well within the 40–60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Conclusion Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises and newly created management structures. Developing comprehensive gender-sensitive health workforce monitoring systems and comparing progress across academic health centres in Europe could help to identify the gender leadership gap and utilise health human resources more effectively.

This original and innovative book opens up new perspectives in health policy debate, examining the emerging international trends in the governance of health professions and the significance of national contexts for the changing health workforce. In bringing together research from a wide range of continental European countries as well as the United Kingdom, Canada and Australia, the contributors highlight different arenas of governance, as well as the various players involved in the policy process. They expand the public debate on professional governance - hitherto mainly limited to medical self-regulation - to encompass a broad span of health care providers, from nurses and midwives to alternative therapists and health support workers. The book provides new data and geopolitical perspectives in the debate over how to govern health care. It helps to better understand both the enabling conditions for, and the barriers to, making professionals more accountable to the interests of a changing public. This book will be a valuable resource for students at an undergraduate and postgraduate level, particularly for health programmes, sociology of professions and comparative health policy, but also for academics, researchers and managers working in health care.