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Performance management in primary healthcare services: evidence from a field study

  • Paulino Silva
  • Aldónio Ferreira
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    Purpose – There is a growing interest in research focusing on performance management practices in the public sector, but research is still limited with regards to public primary healthcare services (PHSs), which play an important role in national healthcare systems. These organisations are frequently criticised for alleged poor performance management practices and misuse of resources, though such claims are not always substantiated. The purpose of this study is to examine performance management practices in public PHSs. Design/methodology/approach – Three case studies of PHSs organisations were conducted resulting in interview material and archival data. Otley's performance management framework was used to examine the data. Findings – It is found that the performance management systems of the studied PHSs were disjoint and lacked consistency and coherence. Lack of direction and motivational were key issues in PHSs. Furthermore, the observations indicate that vertical controls between PHSs and parent organisation were weak and accountability poor. Research limitations/implications – Generalisability of findings and social desirability bias are the important limitations. A key research implication is that the conceptual framework adopted can be meaningfully used to generate insights into performance management issues in public sector healthcare organisations. Practical implications – The study highlights the implications of the poor design and use of performance management systems and highlights areas for improvement in the organisations studied, and potentially across the sector. Originality/value – This study is the first to draw upon Otley's performance management framework to examine performance management practices in PHSs and to demonstrate its usefulness in this context. while the software system “does the work”), as well as considering the broader implications of such diffusion in the context of the recent financial crisis.

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    Article provided by Emerald Group Publishing in its journal Qualitative Research in Accounting & Management.

    Volume (Year): 7 (2010)
    Issue (Month): 4 (November)
    Pages: 424-449

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    Handle: RePEc:eme:qrampp:v:7:y:2010:i:4:p:424-449
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    1. Eldenburg, Leslie & Hermalin, Benjamin E. & Weisbach, Michael S. & Wosinska, Marta, 2004. "Governance, performance objectives and organizational form: evidence from hospitals," Journal of Corporate Finance, Elsevier, vol. 10(4), pages 527-548, September.
    2. Stéphanie Guichard, 2004. "The Reform of the Health Care System in Portugal," OECD Economics Department Working Papers 405, OECD Publishing.
    3. Otley, David T., 1980. "The contingency theory of management accounting: Achievement and prognosis," Accounting, Organizations and Society, Elsevier, vol. 5(4), pages 413-428, October.
    4. Carolyn Stringer, 2007. "Empirical performance management research: observations from AOS and MAR," Qualitative Research in Accounting & Management, Emerald Group Publishing, vol. 4(2), pages 92-114, July.
    5. Dr Gwen M. Hannah & Colin R. Dey & David M. Power, 2005. "Attempts to Improve Accountability in Primary Health Care: Evidence from a GP Practice in Scotland," Qualitative Research in Accounting & Management, Emerald Group Publishing, vol. 2(2), pages 129-151, September.
    6. Bertrand Masquefa, 2008. "Top management adoption of a locally driven performance measurement and evaluation system: A social network perspective," Post-Print halshs-00282391, HAL.
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