Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate professor Erik Gustavsson, Linköping University,
- Second opponent: Associate professor Andreas Brøgger Albertsen, Aarhus University,
- Third member and chair of the evaluation committee: Professor Kristine Bærøe, University of Oslo
Chair of the Defence
Professor emeritus Anne Marit Mengshoel, University of Oslo
Principal Supervisor
Professor Eli Feiring, University of Oslo
Summary
This doctoral thesis examines the framings of and justifications for imposing patient non-attendance fees in public healthcare systems; in particular, it investigates these fees within the context of delivering specialist healthcare in Norway and Denmark.
The first study mapped out the arguments used in the Norwegian public debate about patient non-attendance fees at public specialist outpatient clinics by qualitatively analysing public consultation documents. The second study identified and compared how policymakers in Norway and Denmark have framed and conceptualised patient non-attendance fees at public hospitals by qualitatively analysing policy documents from the two countries. The third study investigated how a panel of people in Norway conceive of patient non-attendance fees in a public specialist healthcare setting by conducting a survey experiment and quantitatively analysing the participants’ ratings of hypothetical vignettes.
Taken together, the findings demonstrate how patient non-attendance fees have been framed and conceived of differently, even in apparently similar contexts. In Norway, fees were articulated as a financial disincentive, devoid of any moral language; in Denmark, they were also framed as an educational measure to foster a sense of social responsibility. Crucially, it was found that there was a mismatch between how policymakers usually frame the fees and how most people conceive of them—as a deserved sanction.
Overall, these findings may help to reach a better understanding of the controversies that often accompany debates on patient non-attendance fees, and they can inform policymaking. Moreover, the different constructs of patient non-attendance fees developed and identified in this project (i.e. non-attendance fees as patient incentive, patient education, provider compensation, opportunity cost compensation and patient sanction) can be conceptually generalised for use in other empirical and theoretical analyses.
Additional information
Contact the research support staff.