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Reputations count: why benchmarking performance is improving health care across the world

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  • Bevan, Gwyn
  • Evans, Alice
  • Nuti, Sabina

Abstract

This paper explores what motivates improved health care performance. Previously, many have thought that performance would either improve via choice and competition or by relying on trust and altruism. But neither assumption is supported by available evidence. So instead we explore a third approach of reciprocal altruism with sanctions for unacceptably poor performance and rewards for high performance. These rewards and sanctions, however, are not monetary, but in the form of reputational effects through public reporting of benchmarking of performance. Drawing on natural experiments in Italy and the United Kingdom, we illustrate how public benchmarking can improve poor performance at the national level through ‘naming and shaming’ and enhance good performance at the sub-national level through ‘competitive benchmarking’ and peer learning. Ethnographic research in Zambia also showed how reputations count. Policy-makers could use these effects in different ways to improve public services.

Suggested Citation

  • Bevan, Gwyn & Evans, Alice & Nuti, Sabina, 2019. "Reputations count: why benchmarking performance is improving health care across the world," Health Economics, Policy and Law, Cambridge University Press, vol. 14(2), pages 141-161, April.
    • Handle: RePEc:cup:hecopl:v:14:y:2019:i:02:p:141-161_00
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    Cited by:

    1. Daniel Adrian Lungu & Elisa Foresi & Paolo Belardi & Sabina Nuti & Andrea Giannini & Tommaso Simoncini, 2021. "The Impact of New Surgical Techniques on Geographical Unwarranted Variation: The Case of Benign Hysterectomy," IJERPH, MDPI, vol. 18(13), pages 1-14, June.
    2. Haaland, Marte E.S. & Haukanes, Haldis & Zulu, Joseph Mumba & Moland, Karen Marie & Blystad, Astrid, 2020. "Silent politics and unknown numbers: Rural health bureaucrats and Zambian abortion policy," Social Science & Medicine, Elsevier, vol. 251(C).
    3. Amerigo Ferrari & Chiara Seghieri & Andrea Giannini & Paolo Mannella & Tommaso Simoncini & Milena Vainieri, 2023. "Driving time drives the hospital choice: choice models for pelvic organ prolapse surgery in Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(9), pages 1575-1586, December.
    4. De Rosis, Sabina & Guidotti, Elisa & Zuccarino, Sara & Venturi, Giulia & Ferré, Francesca, 2020. "Waiting time information in the Italian NHS: A citizen perspective," Health Policy, Elsevier, vol. 124(8), pages 796-804.
    5. Horenberg, Frank & Lungu, Daniel Adrian & Nuti, Sabina, 2020. "Measuring research in the big data era: The evolution of performance measurement systems in the Italian teaching hospitals," Health Policy, Elsevier, vol. 124(12), pages 1387-1394.
    6. Rosanna Le Voir, 2023. "Leaving no One Behind: Displaced Persons and Sustainable Development Goal Indicators on Sexual and Reproductive Health," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 42(5), pages 1-24, October.
    7. Alice Borghini & Ilaria Corazza & Sabina Nuti, 2021. "Learning from Excellence to Improve Healthcare Services: The Experience of the Maternal and Child Care Pathway," IJERPH, MDPI, vol. 18(4), pages 1-10, February.
    8. Anell, Anders, 2019. "Performance management and audit & feedback to support learning and innovation – Theoretical review and implications for Swedish primary care," Papers in Innovation Studies 2019/11, Lund University, CIRCLE - Centre for Innovation Research.
    9. Nuti, Sabina & Ferré, Francesca & Seghieri, Chiara & Foresi, Elisa & Stukel, Therese A., 2020. "Managing the performance of general practitioners and specialists referral networks: A system for evaluating the heart failure pathway," Health Policy, Elsevier, vol. 124(1), pages 44-51.
    10. Oliver, Adam, 2020. "Reviving and revising economic liberalism: an examination in relation to private decisions and public policy," LSE Research Online Documents on Economics 103060, London School of Economics and Political Science, LSE Library.

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