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Analytical perspectives on performance-based management: an outline of theoretical assumptions in the existing literature

Published online by Cambridge University Press:  14 March 2013

Sarah Wadmann ,
Sarah Johansen ,
Ane Lind ,
Hans Okkels Birk  and
Klaus Hoeyer
Sarah Wadmann*
Affiliation:
MSc Public Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
Sarah Johansen
Affiliation:
MSc Public Health, Spine Center Copenhagen, Glostrup University Hospital, Denmark
Ane Lind
Affiliation:
Msc Public Health, The Danish Haemophilia Society, Denmark
Hans Okkels Birk
Affiliation:
Msc Economics, Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; and Region Zealand, Denmark
Klaus Hoeyer
Affiliation:
PhD, MA, Associate Professor, Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
*
*Correspondence to: Sarah Wadmann, MSc Public Health, Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5B, PO box 2099, DK-1014 Copenhagen, Denmark. Email: sala@sund.ku.dk
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Abstract

Performance-based management (PBM) has become a dominant form of governance in health care and there is a need for careful assessment of its function and effects. This article contains a cross-disciplinary literature synthesis of current studies of PBM. Literature was retrieved by database searches and categorized according to analytical differences and similarities concerning (1) purpose and (2) governance mechanism of PBM. The literature could be grouped into three approaches to the study of PBM, which we termed: the ‘functionalist’, the ‘interpretive’ and the ‘post-modern’ perspective. In the functionalist perspective, PBM is perceived as a management tool aimed at improving health care services by means of market-based mechanisms. In the interpretive perspective, the adoption of PBM is understood as consequence of institutional and individual agents striving for public legitimacy. In the post-modern perspective, PBM is analysed as a form of governance, which has become so ingrained in Western culture that health care professionals internalize and understand their own behaviour and goals according to the values expressed in these governance systems. The recognition of differences in analytical perspectives allows appreciation of otherwise implicit assumptions and potential implications of PBM. Reflections on such differences are important to ensure vigilant appropriation of shifting management tools in health quality governance.

Type
Articles
Information
Health Economics, Policy and Law , Volume 8 , Issue 4 , October 2013 , pp. 511 - 527
Copyright
Copyright © Cambridge University Press 2013 

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