A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional…
Abstract
Purpose
A large number of studies indicate that coercive forms of organizational control and performance management in health care services often backfire and initiate dysfunctional consequences. The purpose of this article is to discuss new approaches to performance management in health care services when the purpose is to support innovative changes in the delivery of services.
Design/methodology/approach
The article represents cross-boundary work as the theoretical and empirical material used to discuss and reconsider performance management comes from several relevant research disciplines, including systematic reviews of audit and feedback interventions in health care and extant theories of human motivation and organizational control.
Findings
An enabling approach to performance management in health care services can potentially contribute to innovative changes. Key design elements to operationalize such an approach are a formative and learning-oriented use of performance measures, an appeal to self- and social-approval mechanisms when providing feedback and support for local goals and action plans that fit specific conditions and challenges.
Originality/value
The article suggests how to operationalize an enabling approach to performance management in health care services. The framework is consistent with new governance and managerial approaches emerging in public sector organizations more generally, supporting a higher degree of professional autonomy and the use of nonfinancial incentives.
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The purpose of this paper is to outline the conditions for a new service system in healthcare, which will be able to match the available capacity in and between healthcare units…
Abstract
Purpose
The purpose of this paper is to outline the conditions for a new service system in healthcare, which will be able to match the available capacity in and between healthcare units, in order to match the need of care for the patients.
Design/methodology/approach
By drawing on statements from patients, experiences from similar services (a literature review), empirical research into the effects of the reforms on free choice and the care guarantee and a theoretically informed discussion drawing on value‐creation and service productivity, it is claimed that a matching system is needed to be developed.
Findings
As healthcare lacks incentives and structures of matching capacity between various care providers, and for coordinating episodes of care for the patient, the result is management of capacity that is difficult and uncertain for patients. Continuity and coordination during all the healthcare process are seen as important values by patients. It is valuable for patients to be matched in the coordination of contacts with providers and specialists.
Practical implications
Healthcare matching generates the supportive data for innovative service research. For management, it could be applicable in different organisational areas, for patients in their choices of provider and for the providers, when matching the needs for patients. In further research, it would be of value to discuss the barriers of matching.
Originality/value
Outlining the conditions for a service system, healthcare matching, has not been done before.
Details
Keywords
Kristian Bolin, Sören Höjgård and Björn Lindgren
The Swedish health care system is commonly characterized as a national health-service (or Beveridge) model (Freeman, 2000; Blank and Burau, 2004). It is certainly both financed by…
Abstract
The Swedish health care system is commonly characterized as a national health-service (or Beveridge) model (Freeman, 2000; Blank and Burau, 2004). It is certainly both financed by taxes and organized as a government responsibility, but it has developed over time as a decentralized rather than a national system (Lindgren, 1995). In Europe, only Finland seems to have a more decentralized system (Häkkinen, 2005). Most political decisions on health and health care in Sweden are made at the level of its presently 20 county councils and 290 local municipalities, which are empowered to put proportional income taxes on their citizens in order to finance their activities. Central government has a more passive role. Apart from supervising the fulfilment of the overall objectives of the health care legislation, which has a strong emphasis on equity,1 its influence is primarily manifested through indirect measures such as general and targeted subsidies. It can also impose ceilings on county council and municipality taxes.
Håkan Boter and Anders Lundström
From a literature review and a comprehensive survey aims to analyze how small to medium‐sized enterprises (SMEs) use existing support systems. The analysis is specifically on…
Abstract
Purpose
From a literature review and a comprehensive survey aims to analyze how small to medium‐sized enterprises (SMEs) use existing support systems. The analysis is specifically on focusing different size groups within the SME category, the role of industrial sector, and regional location.
Design/methodology/approach
The combination of macro‐economic theory and entrepreneurial perspectives constitutes the theoretical framework for this study. Empirical data are collected via a survey to over 1,000 Swedish SMEs with one to 49 employees, from both manufacturing and service industries, and from three different regions. Descriptive as well as multivariate statistical techniques are used in the analysis.
Findings
The results indicate low participation rates of available support services and the largest manufacturing companies with a location in sparsely populated areas are the most frequent users. Vague arguments from neo‐classical theory and lack of clarity in definitions of small firms pose an obstacle to the production of empirical results as well as theoretical development. Support users are mainly positive to the services and, although the “take‐up rate” has increased in recent years, a better match between demand and supply of support services must be undertaken.
Originality/value
This paper gives understanding of how the business support programs are received among small companies. The results generated via a large sample size, 1,022 companies, combined with theoretical considerations, give a solid platform for research and policy conclusions.