Abstract:
OBJECTIVE:To explore some of the impacts of star performance ratings in acute hospital trusts in England. METHODS:A multiple case study design was used which incorporated purposeful sampling of 'low' and 'high' performing trusts using the star rating system. In each case study site, data collection comprised semi-structured interviews and documentary analysis. Between eight and 12 senior managers and senior clinicians were interviewed in each organisation. RESULTS:There was a general view that the star ratings as presently constituted did not represent a rounded or balanced scorecard of their own organisation's performance and a widespread belief that the information used to calculate the ratings was often incomplete and inaccurate. The star ratings were viewed by some managers as useful, in that they gave added weight to their trust's modernisation agenda. In addition to driving beneficial change, the ratings were also sometimes reported to have inadvertently induced a range of unintended and dysfunctional consequences, including tunnel vision and a distortion of clinical priorities, bullying and intimidation, erosion of public trust and reduced staff morale, and ghettoisation. CONCLUSIONS:Set in the context of an international body of research, this study highlights some important gaps in knowledge and failings in current policy and practice. In particular, the many dysfunctional consequences of publishing star ratings indicate a need for a re-examination of performance management policies.
journal_name
J Health Serv Res Policyjournal_title
Journal of health services research & policyauthors
Mannion R,Davies H,Marshall Mdoi
10.1177/135581960501000106subject
Has Abstractpub_date
2005-01-01 00:00:00pages
18-24issue
1eissn
1355-8196issn
1758-1060journal_volume
10pub_type
杂志文章abstract:BACKGROUND:Scholarship cites health care managers (HCMs) as not using research evidence in their management practice. The purpose of this review was to evaluate the effectiveness of interventions to enhance HCMs use of research evidence in practice. METHODS:We carried out a systematic review and focus groups to valida...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/1355819618786764
更新日期:2019-01-01 00:00:00
abstract::It has previously been suggested that the English Department of Health seems, wittingly or not, to have drawn on the experiences of Stalinist Russia in devising policies for the National Health Service. The development of general practitioner fundholding during the 1990s could be compared to the Soviet support for the...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960000500311
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVE:the nature of care delivered in emergency departments has changed due to increased demand. In response, one relatively new change is the introduction of a physiotherapy service. There have been anecdotal reports that this may reduce patient waiting times and lead to more effective use of other health care sta...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/jhsrp.2010.009129
更新日期:2011-01-01 00:00:00
abstract::Almost everything you know about heroin addiction is wrong. Not only is it wrong, but it is obviously wrong. Heroin is not highly addictive; withdrawal from it is not medically serious; addicts do not become criminals to feed their habit; addicts do not need any medical assistance to stop taking heroin; and contrary t...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008022
更新日期:2008-04-01 00:00:00
abstract::This paper analyses likely implications of two recent European Court rulings on the provision of health care across borders within the European Union. We argue that the two cases have fundamental implications for the provision of health services as free access to care across borders conflicts with the principle of sub...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960000500408
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:To conduct an economic evaluation comparing a traditional antenatal visiting schedule (traditional care) with a reduced schedule of visits (new style care) for women at low risk of complications. METHODS:Economic evaluation using the results of a randomised controlled trial, the Antenatal Care Project. This...
journal_title:Journal of health services research & policy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/135581960000500203
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVES:To examine the influence of the English National Health Service (NHS) South and West (S&W) region Development and Evaluation Committee (DEC) technology appraisal reports on purchasing and clinical decisions in the S&W and elsewhere in the NHS, and to estimate the cost of the DEC process. METHODS:Two postal ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960300800106
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:Poor people receive shorter consultations in general practice than more affluent people. Our aim was to study the two reasons generally advanced for this for patients consulting with mental health problems: people of low socioeconomic status (SES) demand shorter consultations or they tend to match with practi...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.009034
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVES:Increasingly health care performance data are being disseminated in the form of 'league tables' of health care providers, with the implication that such publication helps purchasers select the better providers, and spurs providers into improvements. This paper examines progress to date. METHODS:Three stages...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/135581969800300111
更新日期:1998-01-01 00:00:00
abstract::This essay considers some limitations of programme theory evaluation in relation to healthcare policies. This approach, which seeks to surface 'programme theories' or construct 'logic models', is often unable to account for empirical observations of policy implementation in real-world contexts. I argue that this failu...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819618779614
更新日期:2018-10-01 00:00:00
abstract::Medicaid waivers have been a principal tool of innovation in health policy in the US since at least the mid 1970s. As Republicans seek to give the states more flexibility in their implementation and management of both Medicaid and the Affordable Care Act or its replacement, waiver authority is likely to be one of the ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819617702175
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To explore the tensions across the primary-secondary interface when referral from primary care is to a team and to inform service developments in other specialties. METHODS:A nested qualitative study within a randomized controlled trial of primary care and Community Mental Health Teams (CMHTs) in Croydon and...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1258/jhsrp.2007.006053
更新日期:2008-01-01 00:00:00
abstract::Understanding the environmental and behavioural predictors of wellbeing is a key driver of health and social care research. Research set in the social world examines the relationships between behavioural, cognitive, emotional and environmental factors, linking these to disease or social ills with the aim of providing ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.010016
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVES:To explore patients' and carers' views on what constitutes high-quality communication and information provision during diagnostic assessment in memory clinic services in three areas of England. METHODS:Interviews with 27 people with cognitive impairment (13 with confirmed dementia) and 26 carers (20 matched...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819613479945
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:To identify factors that explain patient satisfaction with general practice physicians and hence that may drive patients' choice of practice. METHODS:Logistic regression analysis of English National Health Service national patient survey data is used to identify the aspects of general practice care that are...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2007.007055
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Access to cardiac treatments has been documented to vary with patients' age. It is unknown whether these variations reflect patients' treatment preferences. We aimed to investigate patients' preferences for cardiology treatments and develop a Patients' Preferences Questionnaire. METHODS:Semi-structured inte...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008012
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To review the impact of payment systems on the behaviour of primary care physicians. METHODS:All randomised trials, controlled before and after studies, and interrupted time series studies that compared capitation, salary, fee-for-service or target payments (mixed or separately) that were identified by compu...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/1355819011927198
更新日期:2001-01-01 00:00:00
abstract::Though the science of medicine subscribes to learning from best practices and the transmission of superior treatment regimens across national boundaries, the same ethos does not inform political debates surrounding health system reform. The Canadian and English health systems have been used - and, more frequently - ab...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.010141
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVES:To examine the extent to which proximity to the income threshold for free GP care results in significant differences in GP visiting. Approximately 30% of the Irish population receives free GP care (medical card patients), while the remaining 70% pays in full (private patients). Medical card eligibility exert...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008048
更新日期:2008-10-01 00:00:00
abstract::This paper takes an overview of the organizational and managerial literature on recent large-scale change efforts within health care organizations. Such literature refers to issues of enhanced policy significance, as a succession of such changes has swept through health care, at an international level. Interpretive an...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/135581969700200310
更新日期:1997-07-01 00:00:00
abstract::There has been much speculation about whether the National Institute for Health and Clinical Excellence (NICE) has, or ought to have, a 'threshold' figure for the cost of an additional quality-adjusted life-year above which a technology will not be recommended for use. We argue that it is not constitutionally appropri...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907779497567
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:To identify the barriers to shifting services from secondary to primary care perceived by the involved stakeholders. METHODS:Forty-five semi-structured interviews with stakeholders from primary care, acute and community hospitals, purchasers (health authorities) and other agencies involved in two contrastin...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969900400306
更新日期:1999-07-01 00:00:00
abstract::This article raises the concern that biobanks are failing to realize the expected research and health service outcomes. Rather than biobanking, we have been engaging in 'biohoarding', where building a quantifiable collection of tissue samples is the primary basis of the bio-resource. The root cause of 'biohoarding' is...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819615599014
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:Non-surgical treatment can be effective for many musculoskeletal conditions. Improving access to these options may improve the efficiency of hospitals. The Orthopaedic Physiotherapy Screening Clinic and Multidisciplinary Service offers early comprehensive assessment and coordinated, patient-centred care withi...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819614533675
更新日期:2014-10-01 00:00:00
abstract::People with serious and persistent mental illness require a range of community services typically provided by different specialized agencies. At the clinical level, assertive team case management is the strategy commonly used to achieve integration of services across specialized sectors. The USA also has used various ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969700200206
更新日期:1997-04-01 00:00:00
abstract::The way that public involvement in research has been evaluated as a complex intervention has derailed the development of an evidence base. Two alternative approaches are available for constructing and evaluating patient involvement, each of which requires us to revisit the purposes and values that underpin it in each ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819615612510
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:To determine whether geographical areas with relatively low overall hospitalization rates have higher population-based rates of admission of patients with advanced stages of disease. METHODS:Age- and sex-standardized hospital admission rate were calculated for the residents of the 80 Local Health Units in L...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969700200406
更新日期:1997-10-01 00:00:00
abstract::Discussion of unanticipated problems in care with patients and their families ('open disclosure') is now widely advocated. Despite international efforts and the introduction of a range of policies and guidance to promote such discussions, the expectations of policy makers and patients are often not matched in practice...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819614558100
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:This paper focuses upon health status, need for care, and use of health care from 1994/95 to 2000/01 in the Canadian foreign-born population. METHODS:Using Statistics Canada's longitudinal National Population Health Survey, descriptive and survival analyses are used to explore immigrant health status and he...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/1355819053559074
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:The United States Government's Medicaid expansion policy has important implications for health centres, since a large proportion of health centre patients are Medicaid enrollees. The objective of this study was to compare primary care utilization and clinical quality performance between health centres in Med...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819618788592
更新日期:2019-01-01 00:00:00