Den teoretiska utmaningen - En undersökning om nyinstitutionalismens (o)förmåga att förklara förändring.
Tool perspectiveNew institutionalismSymbolic perspectiveTheory testingSwedish health carePolitical and administrative sciencesStatsvetenskapFörvaltningskunskapLaw and Political Science
This thesis aims to examine the possibility of understanding social change by using new institutionalism approaches on a specific case, The case, which describes the implementation of new public management reform in the Swedish health care system, is analysed from two separate new institutionalismperspectives; the tool perspective and the symbol perspective. These approaches differ from one another in the sense that the first relies on a rational choice ontology, while the latter rather refers to a sociological tradition. In the analysis, causal explanations as well as aim related explanations are presented. Formative moments such as economic stagnation, non-socialist governments and ideological isomorfism are presented as important factors behind the reformation. By using the tool perspective, the motives of the idea spreading and reformation of the Swedish health care system, are connected to a strictly rationalbasis such as cost efficiency and quality improvements. According to thesymbolic perspective the motives are rather considered to be the strive forlegitimacy and identity as well as institutionalised expectations. The efficiency of using the two new institutionalism perspectives increaseswhen the case is characterised by a relatively high degree of abstraction, and when they complement each other.