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Unintended responses to performance management in dutch hospital care: Bringing together the managerial and professional perspectives

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  • Emiel Kerpershoek
  • Martijn Groenleer
  • Hans de Bruijn

Abstract

As part of a major health care reform starting in 2005, the Netherlands introduced a Diagnosis-Related Group (DRG) system of hospital care reimbursement and performance measurement. The DRG system was applied to all hospital care, meaning that it affected the overwhelming majority of Dutch specialist medical professionals. To better understand the consequences of this new system, and the responses of medical professionals to its implementation, we conducted and analysed an original set of sixty-six semi-structured interviews focused on medical specialists’ perception and utilization of the system. Our findings indicate that these professionals’ behaviours can seldom be ascribed to financial motives alone. Many responses of medical professionals to the new system were attributed to value-based motivations, related to upholding professional ethos and accommodating the dynamics of the professional process. Even responses that might be characterized at first as financially driven could not be entirely understood as perverse effects of the performance management system, as they too usually had an ancillary aim of safeguarding the professional tenets of the medical establishment.

Suggested Citation

  • Emiel Kerpershoek & Martijn Groenleer & Hans de Bruijn, 2016. "Unintended responses to performance management in dutch hospital care: Bringing together the managerial and professional perspectives," Public Management Review, Taylor & Francis Journals, vol. 18(3), pages 417-436, March.
  • Handle: RePEc:taf:pubmgr:v:18:y:2016:i:3:p:417-436
    DOI: 10.1080/14719037.2014.985248
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    Cited by:

    1. Inkyu Kang, 2023. "How does technology‐based monitoring affect street‐level bureaucrats' behavior? An analysis of body‐worn cameras and police actions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 42(4), pages 971-991, September.
    2. Mads Leth Jakobsen, 2020. "Buy-in to a Credible Vision! Why Leaders Make Prospector Responses to Learning-Oriented Performance Reform," Public Organization Review, Springer, vol. 20(2), pages 277-299, June.
    3. Nicolette van Gestel & Marlot Kuiper & Wiljan Hendrikx, 2019. "Changed Roles and Strategies of Professionals in the (co)Production of Public Services," Administrative Sciences, MDPI, vol. 9(3), pages 1-15, August.
    4. Maria Cristina Ghiotto & Ylenia Rizzolo & Elisa Carraro & Mirko Claus, 2019. "La "cartella informatizzata" del Medico di Medicina Generale nel sistema di valutazione delle performance dell?Assistenza Primaria," MECOSAN, FrancoAngeli Editore, vol. 2019(112), pages 41-59.

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