The interface between the patient and the health service has changed, which constitutes a potential problem for various policy-makers. Using a critical policy perspective and drawing on the theory of problem framing, this paper explores how actor groups with different responsibilities perceive the patient as a constructed policy problem. This is a qualitative study where data consists of single episode interviews with healthcare politicians, senior administrators, service strategists, and unit mangers from one regional health authority in Sweden. A thematic content analysis of the interviews was carried out in accordance with “the framework approach”. The study illustrates how the actors interpret their reality using diverse problem frames. This becomes more visible when the framing is disentangled with regard to what perspective they employ in relation to different accounts: society or the individual, or the (healthcare) system or the (healthcare) professional. The actor groups are part of the same institutional context, which explains certain tendencies of similarities in terms of the accounts being used, but still they approach the constructed problem differently which is visible as shifts—scaling up and down—between different accounts. By analyzing and structuring the various problem frames (including its policy styles) we can enhance our knowledge about how those responsible for the governance of healthcare approach the patient as a policy problem, as something that concerns only the patient and/or the provider, or as something that needs to be addressed in broader strategic terms.

患者和卫生服务之间的接口已经改变，这对各种决策者构成了一个潜在的问题。本文使用批判性政策视角并借鉴问题框架理论，探讨了具有不同责任的参与者群体如何将患者视为一个建构的政策问题。这是一项定性研究，其中数据包括对瑞典一个地区卫生当局的医疗保健政治家、高级管理人员、服务策略师和单位经理的单集访谈。访谈的主题内容分析是根据“框架方法”进行的。该研究说明了参与者如何使用不同的问题框架来解释他们的现实。当框架与他们针对不同帐户使用的视角分开时，这一点变得更加明显：社会或个人，或（医疗保健）系统或（医疗保健）专业人员。参与者群体是同一制度背景的一部分，这就解释了所使用账户的某些相似趋势，但他们仍然以不同的方式处理构建的问题，这在不同账户之间的变化中可见——放大和缩小。通过分析和构建各种问题框架（包括其政策风格），我们可以增强我们对那些负责医疗保健治理的人如何将患者作为政策问题处理的知识，作为仅涉及患者和/或提供者的事情，