Titre :
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Understanding the role of contextual influences on local health-care decision making : case study results from Ontario, Canada. (2001)
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Auteurs :
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Julia ABELSON
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Type de document :
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Article
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Dans :
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Social science and medicine (vol. 53, n° 6, 2001)
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Pagination :
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777-793
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Langues:
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Anglais
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Mots-clés :
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Etat santé
;
Participation communautaire
;
Homme
;
Canada
;
Amérique
;
Amérique du Nord
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Résumé :
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[BDSP. Notice produite par INIST-CNRS 25XR0xHJ. Diffusion soumise à autorisation]. Approaches to involving the public in local health care decision making processes (and analyses of these approach have tended to treat participation and publics uniformly in search of the ideal method of involving the public providing the same opportunities for public participation regardless of differing socio-economic, cultural, insitutio or political contexts within which decisions are made. Less attention has been given to the potential for vari contextual factors to influence both the methods employed and the outcomes of such community decision-mak processes. The paper explores the role that context (three sets of contextual influences more specifically) plays in shap community decision-making processes. Results from case studies of public participation in local health-care decis making in four geographic communities in Ontario are presented. During the study period, two of these communi were actively involved in health services restructuring processes while one had recently completed its process and fourth had not yet engaged in one. Several themes emerge from the case studies regarding the identification and role contextual influences in differentially shaping participation in local health care decision-making. These include propensity for communities with different social and structural attributes to engage in different "styles" participation ; the importance attached to "community values" in shaping both the qualitative and quantitative aspe of participation ; the role of health councils, local government and inter-organizational collaboration as participat "enablers" ; and the politicization of participation that occurs around contentious issues such as hosp closures.
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