The aim of the SWS is to support phenomenon-based research. Taken the large scope of SWS one sub-theme is given special attention to. This theme is linked to questions on how knowledge and information can be used to support and improve the governance of welfare systems, implementation of welfare policies and the agency of patients, customers, citizens, professionals and decision-makers.
The continuing and rapid advances in technology, medicine and information systems have brought in several interconnected policy dilemmas for contemporary welfare systems (adapted from Saltman 2019):
1) In the field of funding and politics several questions and policy and challenges occur. These include issues related to how to identify and appropriate additional revenues (especially in tax-based welfare systems) to pay for current levels of clinical and particularly elderly-focused health and social care and social security. The questions arise also from the point of view of the borders of the welfare systems: what services and social benefits are covered, which population is covered and what is the role of user or client fees in paying for the welfare services. At the same time at societal level there is an increasing need for more efficient and value-based provision of health and social services and allocation of social security funds. This all happens in the context of slow economic growth and decreases in tax revenues. An additional flavor in the mix comes from acute shock such as the COVID-19 pandemic which are putting societies and their welfare systems under new kinds of challenges.
2) Advances in medicine and technology bring forward several opportunities to provide high quality and value-based health care and allocate social security benefits in more effective manner. At the same time several challenges also arise. These relate to questions such as how to upgrade existing services with continually advancing information-based or computer-generated technologies to meet the rapidly rising international standard of care (small and large medical capital equipment; computerized procedure suites such as catheterization and robotic surgery; immunotherapy, biosimilar and now CAR-T pharmaceuticals; gene-based personal medicine) in the existing institutional context. These issues also relate to a number of ethical dilemmas and questions that need to be taken into account when new technologies and treatments are advanced within welfare systems.
3) Organizational and managerial challenges relate to questions such as how to transform the existing organizational and institutional structures so that they would make it possible to take the full advantage of novel technologies, new models of service delivery and value-based approaches available. New ways to deliver services and social security include integrating social care with health services, welfare services with social security, developing new professional arrangements, increasing patients’ selfcare, personalized care and co-production of services, adopting novel treatments, procedures, services, and reducing structural bottlenecks in the system, to name but a few. There is need to understand management challenges, provider incentives and payment models as well as cultural and behavioral aspects that would make change in service systems possible.
4) For citizens, customers and patients, advancements in technology and information systems provide opportunities for self-care, more personalized treatments and services, availability of digital tools and opportunities to participate. However, the streams of data flooding in from various channels at an accelerating rate also challenge the information and especially digital information literacy competences of the individuals who are acting within different roles and with different knowledge capital levels within welfare systems. Furthermore, digitalization of services and information related to health and wellbeing, as well as the impact of digitalization on the availability, accessibility and understandability of information, challenges the equal access to services and information.
All in all, these four aspects that relate to increasing information and knowledge utilisation call for multidisciplinary action. There is a need for a broad take on analysing real-world data across different societal layers and actors. In addition, combining the real-world data sets with other data resources such as policy data, survey and interview data is important for both research and practice. The aim of SWS is to provide multiple views on health and wellbeing representing different levels of knowledge capital and agencies in the system. This kind of holistic and sector crossing approach to welfare systems help to build deeper understanding about the challenges faced by different knowledge users and their different roles. The role of information should also be explored at in different levels, including societal, organisational and individual. The interplay between these various levels offers interesting arenas for research.
Saltman R. 2019. Structural effects of the information revolution on tax-funded European health systems and some potential policy responses https://doi.org/10.1186/s13584-018-0284-2