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Table 1 Framework for evaluating regulation

From: Recentralizing healthcare through evidence-based guidelines - striving for national equity in Sweden

Characteristic

Questions

Concerns

Regulating organization

What kind of organization takes on the role of regulator?

Constitution, formal mandate, reporting or accountability arrangements etc.

Regulatory goal/objectives

What is the purpose of regulation and how explicitly it is stated?

The range of problems or needs addressed

Scope of regulation

What organizations and activities are subject to regulation?

Forms or types of organization (horizontal scope)

Which of their functions or activities (vertical scope)

Regulatory model

Are regulation methods oriented towards deterrence or compliance?

Deterrence: distant, formal adversarial relations, formal sanctions and penalties

Compliance: close, friendly relationships, support, educational activities etc.

Regulatory direction

How are regulatory requirements communicated?

Written standards, guidance on implementation etc.

Regulatory detection

What methods are used for monitoring compliance?

Surveys, inspections, data sources, follow-ups etc.

Regulatory enforcement

What methods are used for enforcement?

Disclosure of findings, incentives, sanctions, financial penalties etc.

  1. Source: Walshe K. Regulating healthcare - A prescription for improvement? Maidenhead: Open University Press; 2003. For clarification purposes some adjustments of Walshe and Shortells’ original model have been made, but no changes of model content.