Comparing, Explaining and Assessing Performance Management Schemes in Three Northern European Health Systems

Fördergeber: Danish Research Council, Laufzeit: Jan 2014 – Dez. 2016, Kooperationsprojekt mit Prof. Dr. Karsten Vrangbæk, Universität Kopenhagen und John Appleby, King’s Fund, London.

Recent scientific contributions to the public management literature have developed descriptive frameworks and provided comparative accounts of performance management schemes at the general  level (Bouckaert & Halligan 2008; Bouckaert & van Dooren 2009; Diefenbach 2009). Other contributions are more concerned with developing tools for performance management (e.g. OECD 1997; Murray& Evans 2003). Yet, most contemporary studies take the observed designs for given, rather than seeking to explain why they have developed particular features or assessing how they work in practice (Taylor 2009). This study aims to provide insight into these shortfalls in the international literature by analysing how the general NPM concept of performance management has been translated into specific performance management systems within a particular sector (health care) in three different countries and assessing whether they support core values within a post-NPM setting emphasizing cooperative, participatory and integrated governance.

The specific research questions are: How are performance management schemes applied in health care sectors in Denmark, Germany and England? Can institutional differences within the three health care systems explain the design choices? How can we assess performance management schemes in regard to their ability to support public values in a post NPM setting?

Health care is a particularly interesting case sector for studying performance management. The first reason is that a number of the key issues of the new public governance such as the need for coordination, joined up governance and holistic intervention approaches are particularly important within health care. At the same time health care is characterised by clear articulation of a number of public value concerns for equity, fairness, robustness, efficiency etc. We can thus investigate our theoretical interest in performance management to support public values and changing governance needs. Secondly, it is a sector with a strong medical scientific tradition for measuring clinical performance and a more recent strong push to combine this with administrative performance data to create comprehensive measurement systems. It can thus be considered a “most-likely” case for designing state-of-the-art measurement systems. Yet, at the same time, the complexity and pressures on health care systems make it an informative case for understanding the potential pitfalls and barriers to utilizing such data for integrated performance management schemes. We can thus investigate the boundaries for PM and our theoretical interest in relations between institutional structure and performance management schemes. Within health care we select three country cases (Denmark, Germany and England) to provide variation on important underlying institutional characteristics within a setting of publicly managed health systems in Europe.

HSU

Letzte Änderung: 31. Juli 2024