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Instrumentality in health care: a response to Adam Oliver

Published online by Cambridge University Press:  06 February 2015

Sandra J. Tanenbaum
Sandra J. Tanenbaum*
Affiliation:
Department of Health Services, Management and Policy, College of Public Health, The Ohio State University, Columbus, OH, USA
*
*Correspondence to: Professor Sandra Tanenbaum, Department of Health Services, Management and Policy, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA. Email: tanenbaum.1@osu.edu
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Abstract

In his paper, ‘Incentivizing improvements in health care delivery’, Adam Oliver discusses recent efforts to manage the performance of health care workers in the United States and United Kingdom. Overall, the results of performance management seem to be mixed, but Oliver’s discussion hints at a more fundamental question about this approach, specifically: what are the limits of a focused instrumentality in a context as rich, fluid and collaborative as the delivery of health care? Might performance management schemes actually frustrate the efforts of conscientious health care workers? Indicators make few allowances for the heterogeneity of treatment effects or patient values or preferences. Health care workers may also face pressure to appear to satisfy indicators that are actually impossible to satisfy.

Type
Special Section
Information
Health Economics, Policy and Law , Volume 10 , Issue 3 , July 2015 , pp. 361 - 365
Copyright
© Cambridge University Press 2015 

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References

Groopman, J. and Hartzband, P. (2009), ‘Why “quality” care is dangerous’, Wall Street Journal, 8 April, http://online.wsj.come/articles/SB123914878625199185# [27 October 2014].Google Scholar
Jaffe, G. and O’Keefe, E. (2014), ‘Obama accepts resignation of VA Secretary Shinseki’, Washington Post, 30 May, http://www.washingtonpost.com/politics/shinseki-apologizes-for-va-health [4 July 2014].Google Scholar
Oppel, R. A. and Goodnough, A. (2014), ‘Doctor shortage is cited in delays in V.A. hospitals’, New York Times, 29 May, http://www.nytimes.com/2014/05/30/us/doctor-shortage-cited-in-va- [30 May 2014].Google Scholar
Oppel, R. A. and Shear, M. D. (2014), ‘Severe report finds V.A. hid waiting lists at hospitals’, New York Times, 28 May, http://www.nytimes.com/2014/05/29/us/va-report-confirms-improper [29 May 2014].Google Scholar
Pogach, L. M., Tawari, A., Maney, M., Mangala, R., Miller, D. R. and David, A. (2007), ‘Should mitigating comorbidities be considered in assessing healthcare plan performance in achieving optimal glycemic control? American Journal of Managed Care, 13: 133–140.Google ScholarPubMed
Stone, D. (2012), Policy Paradox: The Art of Political Decision Making, 3rd edn, New York, NY: Norton.Google Scholar
Tanenbaum, S. J. (2009), ‘Pay-for-performance in medicare: evidentiary irony and the politics of value’, Journal of Health Politics, Policy and Law, 34(5): 713–742.Google Scholar
Tanenbaum, S. J. (2012), ‘Improving the quality of medical care: the normativity of evidence-based performance standards’, Theoretical Medicine and Bioethics, 33(4): 263–277.Google Scholar