Towards performance governance in healthcare: An analysis of Italian local health units

IF 1.9 4区医学 Q3 HEALTH POLICY & SERVICES

International Journal of Health Planning and Management Pub Date : 2024-08-13 DOI:10.1002/hpm.3844

Andrea Bonomi Savignon, Lorenzo Costumato, Fabiana Scalabrini, Maddalena Sanchietti

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引用次数: 0

Abstract

Purpose

Bouckaert and Halligan (2008) proposed four ideal types of performance management systems, ranging from a disconnected and input-led approach (performance administration) to a model in which performance management is fully integrated with both the internal and external context of an organisation (performance governance). This article empirically analyzes performance plans issued by Italian Local Health Units (LHUs) to provide a first nationwide snapshot of the different ideal-types of performance management that each (LHUs) have reached, in a ‘performance governance’-oriented perspective.

Design

This paper employs a qualitative methodology based on document analysis. The model orienting the analysis features six dimensions capturing the ideal-types characteristics and what the Italian performance regulations prescribe. Data was derived from the performance plans adopted by the Italian LHUs on the condition that they made the documentation necessary for the analysis public on their institutional website.

Findings

For a ‘performance governance’ oriented approach, two elements are considered relevant: familiarity with the analysis of stakeholders and context. In our sample, consisting of 63 performance plans out of 99 Italian LHUs, it was challenging to identify specific territorial clusters, due to significant heterogeneity. The role of strategic objectives, integration between cycles, and context analysis seems to positively influence the orientation towards a ‘performance governance’ approach.

Originality/Value

The application of Bouckaert and Halligan's ideal-types has only been episodically investigated in the healthcare sector, mainly at the individual health unit or Region level. This article's innovative contribution consists of conducting a qualitative analysis based on a replicable taxonomy that enables further national comparisons. Furthermore, it highlights the need for public healthcare systems to engage more with external stakeholders to improve the quality of their performance governance.

查看原文本刊更多论文

实现医疗保健的绩效管理：对意大利地方医疗单位的分析。

目的：Bouckaert 和 Halligan（2008 年）提出了绩效管理系统的四种理想类型，从互不关联、以投入为主导的方法（绩效管理）到绩效管理与组织内外部环境完全融合的模式（绩效治理）。本文对意大利地方卫生单位（LHUs）发布的绩效计划进行了实证分析，以 "绩效治理 "为导向，首次在全国范围内对各地方卫生单位（LHUs）已达到的不同理想绩效管理模式进行了概括：本文采用基于文件分析的定性方法。本文采用了基于文件分析的定性分析方法，分析模型包括六个方面，分别体现了理想类型的特征和意大利绩效管理条例的规定。数据来源于意大利 LHU 通过的绩效计划，条件是这些 LHU 在其机构网站上公开分析所需的文件：对于以 "绩效管理 "为导向的方法而言，有两个要素被认为是相关的：熟悉利益相关者的分析和背景。在我们的样本中，99 个意大利 LHU 中有 63 个绩效计划，由于差异很大，要确定具体的地区集群具有挑战性。战略目标的作用、各周期之间的整合以及背景分析似乎对 "绩效治理 "方法的取向产生了积极影响：Bouckaert 和 Halligan 的理想类型在医疗保健领域的应用只进行过偶发性研究，主要是在单个医疗单位或地区层面。本文的创新之处在于根据可复制的分类标准进行了定性分析，从而能够进一步进行全国性比较。此外，文章还强调了公共医疗系统与外部利益相关者进行更多合作以提高其绩效管理质量的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Health Planning and Management Multiple-

CiteScore

4.50

自引率

3.70%

发文量

197

期刊介绍： Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.