IDEAS home Printed from https://ideas.repec.org/p/ssf/wpaper/200704.html
   My bibliography  Save this paper

Designing performance measurement systems in health care: multiple organizational players and their interaction in the case of the prevention services in tuscany

Author

Listed:
  • Lino Cinquini

    () (Laboratorio MeS, Scuola Superiore Sant’Anna, Pisa, Italy)

  • Milena Vainieri

    () (Laboratorio MeS, Scuola Superiore Sant’Anna, Pisa, Italy)

  • Cristina Campanale

    () (Laboratorio MeS, Scuola Superiore Sant’Anna, Pisa, Italy)

Abstract

The designing of a performance measurement system usually involves several players, the number and the role of the players in building new performance measurement tools depending on the features affecting the type of organization. Among them, health care units can be considered as some of the most complex to manage (“Running even the most complicated corporation must sometimes seem like child’s play compared to trying to manage almost any hospital.”, Mintzberg and Glouberman 2001), being based on professionals’ activity. Professionals play a wide span of autonomy and they can resist towards changes and control systems that do not involve them, thus implicating their deep involvement in designing and implementing effective management control devices. Due to this characteristic, the decision makers about measurement systems in public health are not only the politics and top managers at different levels (national, regional and local) but also the professionals at their level. But which are the roles of these players at their organizational levels? Do they play a different role in desing and implementation of a performance measurement system? And which are the interactions among them? The aim of this paper is to answer at these questions through the experience of the design of the so-called Prodotti Finiti system for measuring output and performance of the prevention services in Tuscan health care system. The necessity of this performance measurement system rises from a lack that regards the primary care and the collective prevention services: while in the hospital services the DRGs system has been developed and used as a shared tool to measure output and performance, in the primary care and the collective prevention services there is no shared and uniform way to measure the services provided. The idea of using the Prodotti Finiti (Final Products) as objects of performance measurement of prevention services was born at a local level in 1998; then, in 2006, it was spread to all LHAs by the regional level in order to have a uniform and shared system. The players involved in this initiative have been the local and regional levels as the promoter of the introduction of the Prodotti Finiti system and the groups of professionals as the decision-makers of what products and what elements should have to be measured. In the experience of the design of this system the professionals seem to have been the strongest decisional level: they have decided what were the objects to be measured. The political levels (regionals and local) could choose to limit the analysis to some products (as key performance areas) or to some particular elements of the products but these were second hand choices because strictly linked to the assumptions and the decisions already made by professionals. Although the choice of involving professionals in the design of the measurement system is fundamental for the consensus, it could lead to a limited power of the other decision makers, so confirming the strenght of professionals’ power in designing performance measurement systems in health care organizations.

Suggested Citation

  • Lino Cinquini & Milena Vainieri & Cristina Campanale, 2007. "Designing performance measurement systems in health care: multiple organizational players and their interaction in the case of the prevention services in tuscany," Working Papers 200704, Scuola Superiore Sant'Anna of Pisa, Laboratorio MeS.
  • Handle: RePEc:ssf:wpaper:200704
    as

    Download full text from publisher

    File URL: http://www.meslab.sssup.it/wp/200704.pdf
    Download Restriction: no

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ssf:wpaper:200704. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Gaetano Esposito). General contact details of provider: http://edirc.repec.org/data/messsit.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.