Andrew C Twaddle

• Ph.D
• Professor Emeritus at University of Missouri

Preface To Market, To Market...: The New Politics of Medical Care in Sweden Factors Underlying Recent Changes in the Swedish Medical Care System: Theoretical Considerations The Nature and Scope of This Study The Medical Care Crisis: What It Is, If It Is The Crisis in the Economy The Political Crisis Socioeconomic Trends, Ideology and Medical Care R...

Medical care reform throughout the world focuses on increasing 'market' influences on the 'production' and 'distribution' of services. In this paper we explore the tradeoffs in these reforms by first distinguishing three modes of organizing medical services: professional, democratic, and market. Dimensions of each mode are described. Decision makin...

Health care reform efforts internationally are focused more on efficiency than on effectiveness or equity. We lack a coherent theoretical framework for understanding those reforms or for engaging in comparative research. This paper presents some theoretical ideas that could contribute to such a framework. A model constructed from expert opinion sug...

Treating medical specialties as segments, Swedish ambulatory care physicians were interviewed to identify their perspectives on work and the medical care system. Those perspectives were analyzed and compared across segments. Physician segments differed substantially in the themes they put forward. Perspectives tended to be homogeneous within segmen...

This paper reports the results of focused interviews in 1978-1979 with Swedish physicians in private practice about the public system of medical care in Sweden. They were asked about the system as a work environment for physicians and as a system of care for patients. Respondents, who were outside the public system (although financed mainly by publ...

This paper reports the results of focused interviews with child health and maternal health physicians in the public ambulatory care sector of a large Swedish city to describe (1) the organization of their work activities, (2) their perspectives on their work, and (3) their perspectives on the medical care system. Child health physicians (who were a...

This paper is based on in-depth interviews with members of Sweden's medical interest groups involved in a national effort to control health care costs. Sweden is faced with escalating costs due primarily to a growing high technology hospital sector. Simultaneously, consumer demand for primary care services and for gerontological care is rising rapi...

Interviews with district general practitioners in a large Swedish city in 1978-1979 solicited their perspectives on the frustrations and satisfactions they felt in their work, and on the successes and failures of the Swedish medical care system. With respect to work, four themes emerged: medical routine, patient centered care, overwork and isolatio...

This paper reviews the work of the Swedish Commission of Inquiry formed in 1975 to propose a new law governing medical care. Based on interviews with commission members, the interests and goals of participating groups are identified. These are compared to the outcome as published in the final report in 1980. Consumer interests gained few of their o...

Sweden stands as a prototype system in making full political commitment to eliminating financial and geographic barriers to medical care. Yet the high cost of the commitment is a factor in the nation's high marginal tax rate, the issue that toppled the goverment in April 1981. The apparent inability of the modern welfare state to provide medical se...

In the past two decades sociologists have become interested in questions of illness and sickness beyond the search for social factors associated with diseases. The work in this area has led to the concept of sickness as a form of deviant behavior, the identification of distinctive “sick roles”, and investigation of the decision making processes ass...

This paper addresses the problem of the effects of a total institution (Goffman, 1961) environment on the use of medical services. The empirical focus is on a midwestern United States penitentiary for men. Three components of the problem are identified: the difference between the incidence of physician visits as compared with a 'free' population, v...

Not a new but an accelerated trend, non-physician health workers (NPHWs) have been introduced in practice in response to demand, technology, specialization, and large-scale bureaucratic organization of services that is becoming typical of medical practices outside as well as in the hospital. The new situation is that workers are now entering therap...

Given the historical and conceptual links between the concepts of status and role [1–3], it is suprising that the relative little attention has been given to the problem of conceptualizaing health as a social status. This problem is the focus of the present paper. It is argued that thealth and illness can be conceptualized in a specifically sociolo...

Illness has many facets. It is a phenomenon that is at once bio-physical, social, psychological and cultural in nature. Today this is a commonplace observation, even if there is disagreement as to what particular events should be called illness. At the same time, it is relatively new. Only recently has illness become an event for which explanations...

The extent to which hospitalization might be reduced is an important problem for medicine, which makes the identification of preventable admissions and sources of prevention “failures” a question of practical interest. To the extent that preventable admissions are outcomes which relate to population characteristics and social structure, they are so...

An exploratory study of factors leading to preventable hospital admissions focusing on a medical ward population found a large proportion of patients with preventable illnesses or illnesses sufficiently modifiable to have made admission avoidable. This report presents methods for assessing preventability and some preliminary findings relative to pa...

Thesis (Ph. D.)--Brown University. Bibliography: l. 306-312. Microfilm.

Case interviews are used to explore variations in illness behavior and Parsons' sick role formulation. A decision-making model, focusing on the influence of status and role definers (significant others), produced findings relative to the nature of being "well", assignment of a "sick status", and illness behavior. While Parsons' formulation describe...

This article has no abstract; the first 100 words appear below. The issue of consumer participation in medical-care plans has been hotly debated for many years. The chief virtue of this volume is that it sheds some empirical light on a topic that heretofore has generated only heat. Schwartz has carefully selected six physician-controlled and six co...