ABSTRACT
Introduction Healthcare changes or reforms are different from health programmes because they aim to change how healthcare organisations work, rather than intervening directly with patients or populations. An example of a change to organisation is computerising a patient records system. Examples of reforms are the many decentralisation reforms carried out in the Nordic countries (Alban and Christiansen, 1995; Brogren and Brommels, 1990; Hakkinen, 1997).
