Autonomy and Quality in Care. The comparative case of multilevel governance in local service provision for the elderly and the mentally ill

The project "Autonomy and Quality in Care. The comparative case of multilevel governance in local service provision for the elderly and the mentally ill" has developed new knowledge relevant to strengthen local institutional capacity to meet the challenges from increase in number of service receivers. The project has gained insight in how effective, comprehensive and qualitative good service provision can be ensured. The institutional and multilevel governance perspectives used showed that governance is changing targeting results and processes locally. This includes reorienting the provider organizations towards prevention and activation of users. The perspective is combined with a user and profession oriented perspective showing a change in user involvement towards a hierarchical mode of governance due to the implementation of NPM-inspired organizational forms. Quantitative and qualitative analyses are carried out to analyze the implementation of national policies and norms, how they are translated and interpreted locally and forming services for the elderly and mentally ill. The project has identified organizational, professional and financial barriers to collaboration and cooperation.

QUALICARE aims at developing new knowledge relevant to strengthen local institutional capacity to meet the challenges from increase in numbers and complexity of service receivers, from elderly 67+ to younger persons with physical or mental impairments, an d gain new insight in how effective, comprehensive and qualitative good service provision can be ensured. This will be studied combining a institutional and multi-level governance perspective with a user and professional perspective. The project will prov ide an overview of the content, quality and effectiveness of human services provided for elderly and mentally ill in Norwegian municipalities by means of quantitative analyzes of databases (KOSTRA, IPLOS; the Commune database, the organisation database) a nd two surveys already conducted by NIBR. In order to gain new insight in how national policies and norms are implemented, translated and interpreted locally and forming services for the elderly and mentally ill the project will conduct a comprehensive ca sestudy, including document studies and interviews at national level, regional state level and in six Norwegian municipalities (political and administrative leadership, professional leaders, professional carers and users of services). By means of the case study the project seeks to identify organisational, professional and financial barriers to interaction and cooperation, and increase the insight in how these barriers can be removed.