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Research article
Aud Mette Myklebust
Universitetet i Sorost-Norge - Campus Drammen
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5315-7250
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Implementation of the Norwegian government’s Coordination Reform (2012) aims to decentralise health care services from centralised hospitals to the local communities. Radiological services in Norway are mainly organised in hospitals, because of the significant financial and human resource demands engendered by the need for advanced technological equipment, and specialised staff. Some selected conventional x-ray services have been decentralised into rural communities. The purpose of this case study was to evaluate different stakeholders’ perceptions of organizing decentralised radiological services in a rural area in Norway.
Methods
Following an extensive policy and literature review and a survey of GPs in the rural area being investigated two focus groups were conducted to obtain stakeholder’s evaluation of the radiological services in both hospital and rural contexts. The key emergent themes from the literature - decentralization, quality, professional roles, organisation and economic consequences – were discussed with each focus group. Thematic analysis was used for analyzing the primary data collected.
Results
Four main themes emerged from the focus groups: organisation, quality, funding of radiological services and cooperation between health care professions and health care levels. The quality of service was found to be inadequate in some areas because of the superficial level of training given to non-radiographic staff. It was found that the organisation of decentralised radiological services to rural areas is challenging because of the way health services are structured in Norway. This structural framework increases the need for effective cooperation and responsibility between health care professions and levels. There needs to be improved co-working by clearly defining roles and responsibilities.
Conclusions
The stakeholders agreed that decentralized radiological services is important. Quality of the service could be improved and should be given priority. A key recommendation for the organisation of rural radiological service was the development of a satellite link with an acute hospital. Structural change to the financial system whereby money follows patients, might also facilitate more patient-centred services across healthcare levels. Improved mutual understanding between rural radiological services and hospital specialists and managers is important for a high quality and consistent radiological service to be delivered across Norway.
Keywords
case study, decentralized radiological service, organisation, quality, cooperation, funding
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CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Submission checks complete
On 03 Dec, 2019
Editorial decision: Accept
On 02 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 27 Nov, 2019
Editor assigned
On 11 Nov, 2019
Editor invited
On 10 Nov, 2019
Submission checks complete
On 07 Nov, 2019
Version 1
Posted 22 Jul, 2019
No comments provided
Review #2 received
Received 08 Oct, 2019
Editorial decision: Major revision
On 08 Oct, 2019
Reviewer #3 agreed
On 07 Oct, 2019
Reviewer #2 agreed
On 05 Oct, 2019
Review #1 received
Received 02 Oct, 2019
Reviewer #1 agreed
On 28 Aug, 2019
Submission checks complete
On 17 Jul, 2019
Editor assigned
On 17 Jul, 2019
Reviewers invited
Invitations sent on 17 Jul, 2019
Editor invited
On 16 Jul, 2019
First submitted
On 13 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nuclear Medicine & Medical Imaging
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Health Services Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Aud Mette Myklebust
Universitetet i Sorost-Norge - Campus Drammen
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5315-7250
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Submission checks complete
On 03 Dec, 2019
Editorial decision: Accept
On 02 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 27 Nov, 2019
Editor assigned
On 11 Nov, 2019
Editor invited
On 10 Nov, 2019
Submission checks complete
On 07 Nov, 2019
Version 1
Posted 22 Jul, 2019
No comments provided
Review #2 received
Received 08 Oct, 2019
Editorial decision: Major revision
On 08 Oct, 2019
Reviewer #3 agreed
On 07 Oct, 2019
Reviewer #2 agreed
On 05 Oct, 2019
Review #1 received
Received 02 Oct, 2019
Reviewer #1 agreed
On 28 Aug, 2019
Submission checks complete
On 17 Jul, 2019
Editor assigned
On 17 Jul, 2019
Reviewers invited
Invitations sent on 17 Jul, 2019
Editor invited
On 16 Jul, 2019
First submitted
On 13 Jul, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Nuclear Medicine & Medical Imaging
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background
Implementation of the Norwegian government’s Coordination Reform (2012) aims to decentralise health care services from centralised hospitals to the local communities. Radiological services in Norway are mainly organised in hospitals, because of the significant financial and human resource demands engendered by the need for advanced technological equipment, and specialised staff. Some selected conventional x-ray services have been decentralised into rural communities. The purpose of this case study was to evaluate different stakeholders’ perceptions of organizing decentralised radiological services in a rural area in Norway.
Methods
Following an extensive policy and literature review and a survey of GPs in the rural area being investigated two focus groups were conducted to obtain stakeholder’s evaluation of the radiological services in both hospital and rural contexts. The key emergent themes from the literature - decentralization, quality, professional roles, organisation and economic consequences – were discussed with each focus group. Thematic analysis was used for analyzing the primary data collected.
Results
Four main themes emerged from the focus groups: organisation, quality, funding of radiological services and cooperation between health care professions and health care levels. The quality of service was found to be inadequate in some areas because of the superficial level of training given to non-radiographic staff. It was found that the organisation of decentralised radiological services to rural areas is challenging because of the way health services are structured in Norway. This structural framework increases the need for effective cooperation and responsibility between health care professions and levels. There needs to be improved co-working by clearly defining roles and responsibilities.
Conclusions
The stakeholders agreed that decentralized radiological services is important. Quality of the service could be improved and should be given priority. A key recommendation for the organisation of rural radiological service was the development of a satellite link with an acute hospital. Structural change to the financial system whereby money follows patients, might also facilitate more patient-centred services across healthcare levels. Improved mutual understanding between rural radiological services and hospital specialists and managers is important for a high quality and consistent radiological service to be delivered across Norway.
Figure 1
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