Making Sense of Hospital Discharge for Older Adults: Framing Interprofessional Collaboration in Swedish Policymaking

Inadequate interprofessional collaboration presents a challenge when older adults transition from hospital to home care, as this process involves multiple health and social care professionals. To address this, the Swedish Care Coordination Act (CCA) was introduced in 2018, which altered the procedures for care planning and redistributed responsibilities among health and social care actors. This article explores how hospital discharge policies shape the landscape of collaborative care planning for older adults by studying the framing of problems and solutions related to the CCA. Policy documents related to the legislation were analysed by drawing on concepts developed in framing theory, specifically the sense‐making of different policy interests and the overall policy storytelling. The analysis shows one main problem description, named ‘waiting time’ for patients, and three frames defining causes, blame and solutions: the outdated legislation frame, the healthcare involvement frame and the bureaucracy frame. The main problem and the outdated legislation frame unified the political ambitions with the interests of local and regional policy actors, while the healthcare involvement frame and the bureaucracy frame were based on interests deriving from the municipalities and the regional councils, respectively. The policy storytelling was based on taking the policy actors’ interests and perceptions of blame into account, making it possible to merge the different objectives. In conclusion, the frames were largely derived from the professional actors’ interests, assigning interprofessional collaboration difficulties to professional deficits rather than working conditions and resource allocation. The patient perspective was essentially absent from all three frames, which may contribute to upholding professional control of the discharge process. The findings suggest that it is vital to consider the neglected aspects of patient participation and working conditions when creating hospital discharge policy.