Governing by commissioning services - Implementing alcohol screening and brief interventions in hospital settings in Norway

Ole Næss, Tor-Johan Ekeland, Espen Ajo Arnevik, Janne Aarstad and Torgeir Gilje Lid

Evaluation and Program Planning, 2023, vol. 98, issue C

Abstract: Norwegian health services have undergone marked logistical changes in organization and funding over recent decades. One significant change was the new public management-inspired commissioner’s document, first issued in 2013 by the Norwegian Ministry of Health and Care Services, to establish medical and surgical departments’ identification of patients with underlying substance abuse problems (Ministry of Health and Care Services, 2013). Herein, we investigate how multiple stakeholders and actors, who bear responsibility in regional and local health trusts, have responded to the commissioned services to establish routines for identifying alcohol and substance abuse problems among patients admitted to medical and surgical wards. First, an extensive literature search was conducted. Second, we conducted qualitative interviews with informants who have responsibility for applying the commissioner’s document in regional health authorities and local hospitals. The study results demonstrate that responsible actors at all levels take establishing alcohol routines seriously, and that hospitals’ self-assessment of their achievements on internal goals indicate that they have made satisfactory progress. Nevertheless, improvement is needed to meet the goal of discussing alcohol use with all patients admitted to medical and surgical wards within local health trusts. Recommendations for the next steps, based on these findings, include further research and training priorities.

Keywords: Alcohol; Medical and surgical wards; Specialist drug and alcohol services; Commissioner’s document; Regional health authorities; Local health trusts; Ministry of Health and Care Service; Responsible actors (search for similar items in EconPapers)
Date: 2023
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Persistent link: https://EconPapers.repec.org/RePEc:eee:epplan:v:98:y:2023:i:c:s0149718923000484

DOI: 10.1016/j.evalprogplan.2023.102271

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