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Integrated care in Switzerland: strengths and weaknesses of a federal system
- Authors:
- FILLIETTAZ Severine Schussele, et al
- Journal article citation:
- International Journal of Integrated Care, 21(S2), 2021, p.10. Online only
- Publisher:
- International Foundation for Integrated Care
Introduction: Switzerland’s fragmented healthcare system mirrors its federal structure and mix of cultures and languages. Although the Swiss have a higher life expectancy than most of their neighbours, their healthcare system faces similar challenges that call for more integrated care (IC). Aim/Method: This article aims to provide insight into the specificities of and latest developments in Switzerland’s healthcare system and how they may have influenced the development and implementation of IC there. Description/Discussion: The number of local IC initiatives has been growing steadily for 20 years. With a certain lag, various policies supporting IC have been established. Among them, a recent democratic debate on the federal mandatory health insurance law could either induce a radical move towards centralised support for IC or continue to support scattered local IC initiatives. Conclusion: In the future, Switzerland’s healthcare system will probably navigate between local IC initiatives and centralised, federal support for IC initiatives. This will be the reflection of a very Swiss way forward in a world without clear evidence on whether centralised or decentralised initiatives are more successful at developing IC. (Edited publisher abstract)
Evaluation of legislation: skating on thin ice
- Author:
- BUSSMANN Werner
- Journal article citation:
- Evaluation, 16(3), July 2010, pp.279-293.
- Publisher:
- Sage
The challenges and methods of evaluating legislation and statutes are explored. The article describes the methodology and the costs of eight all-encompassing evaluations of statutes at Swiss federal level. It then presents approaches to evaluating statutes. A distinction is made between statutes with the aim of problem-solving and those relating to social ordering. While the former are concerned with a ‘policy’ (objectives combined with intervention instruments), the latter are concerned with the ‘basic order’, which regulates the rights and indirectly the interactions of various actors, but which does not seek a specific outcome. A good part of the legislation aimed at problem-solving can be broken down into its main components; the evaluation of these components does not necessarily differ from the evaluation of programmes. Quite often, however, this approach is not feasible for various reasons. Strategies are presented to evaluate statutes in a more comprehensive manner.
A cross-national and comparative classification of in-country awareness and policy responses to ‘young carers’
- Authors:
- LEU Agnes, BECKER Saul
- Journal article citation:
- Journal of Youth Studies, 20(6), 2017, pp.750-762.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The reality for many families where there is chronic illness, mental health problems, disability, alcohol or substance misuse is that children under the age of 18 are involved in caring. Many of these children – known as ‘young carers’ – will be providing regular and significant care, either episodically or over many years, often ‘hidden’ to health, social care and other welfare professionals and services. These children have most often been invisible in social policy and professional practice. What are the reasons why some countries recognise young carers as a priority for social policy while others (most) do not? What are the key factors that influence a country’s awareness and responses to these children? This article provides an original classification and analysis of country-level responses to young carers, drawing on published research, grey literature, policy documents and the authors’ extensive engagement in policy and practice networks for young carers and their families in a wide range of countries. The analysis identifies two of the key factors that influence the extent and nature of these policy responses, focusing on the importance of a reliable in-country research base and the contribution of influential national NGOs and their networks. (Publisher abstract)
Understanding the recent expansion of Swiss family policy: an idea-centred approach
- Author:
- KUEBLER Daniel
- Journal article citation:
- Journal of Social Policy, 36(2), April 2007, pp.217-237.
- Publisher:
- Cambridge University Press
- Place of publication:
- Cambridge
Conventional theoretical models of the welfare state have difficulties in accounting for the recent expansion of family policies in mature welfare states. This article uses an idea-centred approach, the Advocacy Coalition Framework (ACF), to understand recent family policy change in Switzerland. In a review of conflicts over the introduction of paid maternity leave as well as child day care during the 1990s, two competing advocacy coalitions were identified. The first coalition aimed at restricting government programmes to the prevention of poverty of families, whereas the second advocated the inclusion of measures for the promotion of gender equality. Towards the end of the 1990s, some members of the first advocacy coalition revised their policy core beliefs and changed coalitions, as a consequence of cognitive framing strategies pursued by gender equality advocates. This led to a power shift within the family policy subsystem, resulting in major change of government programmes at all state levels. It is concluded that, on the basis of the ACF, family policy expansion can be coherently traced back to value orientations and cognitive processes.