Effects of New Control Systems in Swedish Health Care Organizations

Charpentier, Claes; Samuelson, Lars Å.

doi:10.1111/j.1468-0408.1996.tb00185.x

Cited by 11 publications

(6 citation statements)

References 12 publications

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“…Even if purchasers do not take on the role of institutional actors per se, the demands associated with the implementation of more 'pure' market-based models for the provision of public services are likely to prompt provider organizations to compile performance indicators conflicting with the interests of professional groups within provider organizations and funding bodies. In contrast, such conflicts seem to be less pronounced in more regulated systems for contracting, characterized by greater political intervention in pricing decisions and less coercive imposition of performance standards, as in the case of Swedish health care (Paulsson, 1993;Charpentier and Samuelson, 1996). Similarly, it has been argued that striving for greater transparency and improved information sharing between stakeholders are essential elements of the post-1997 reforms in the U.K.'s NHS initiated by the new labour government, which in effect mark greater political intervention in the provision of services compared with the market-based model previously in place (Jones, 1999).…”

Section: Proposition 2 the Greater The Institutional Pressures Exertementioning

confidence: 99%

An institutional perspective on performance measurement and management in the ‘new public sector’

Brignall

Modell

2000

Management Accounting Research

648

661

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Section: Proposition 2 the Greater The Institutional Pressures Exertementioning

confidence: 99%

An institutional perspective on performance measurement and management in the ‘new public sector’

Brignall

Modell

2000

Management Accounting Research

648

661

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“…On the other hand, doctors who took only new administrative positions, such as clinical managers, reported a higher level of influence over their work (Petterson, 1999). The introduction of performance-based financing systems appears to have had a particularly strong impact in that it forced doctors to report all treatment decisions, leading to a general sense of bureaucratization (Charpentier and Samuelson, 1996; Kastberg and Siverbo, 2007). Autonomy over the organization of work was also challenged by new forms of clinical leadership.…”

Section: Npm In Swedish Health Care: What Effects On the Professional...mentioning

confidence: 99%

Have the Welfare Professions Lost Autonomy? A Comparative Study of Doctors and Teachers

Blomqvist

Winblad

2022

J. Soc. Pol.

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This article investigates the impact of NPM reforms on two prominent welfare state professions; medical doctors and teachers. The case study context is Sweden, where the impact of NPM led to a series of reforms in health care and education after 1990. The focus in the paper is on professional autonomy, which can be seen as a core trait in professional work. The findings in the article point to both medical doctors and teachers having lost professional autonomy as a result of NPM-reforms, particularly with regards to the dimensions of work organization and evaluation. Autonomy in individual decision-making seems to have been least affected, even if there are indications of this being infringed upon as well. Despite these broad similarities, the loss of autonomy is found to be more pronounced in the case of teachers. One reason behind this difference, which manifests itself in teachers having become subject to higher level of direct administrative control by school managers while at the same time experiencing a more distinct loss of autonomy to evaluate their work, appears to be that medical doctors have been more successful in establishing themselves as experts in relation to new public audit agencies.

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“…The public health care system in Sweden has undergone far-reaching reforms in recent years, in many cases aiming at the implementation of market-based control systems based on purchaser:provider splits (Charpentier and Samuelson, 1996;Lindkvist, 1996;and Paulsson, 1993). However, an important difference compared with other European countries experiencing similar changes, such as the UK, is that the fundamental governance structure and system of funding are highly decentralised.…”

Section: The Research Settingmentioning

confidence: 99%

Integrating Management Control and Human Resource Management in Public Health Care: Swedish Case Study Evidence

Modell

2000

Financ Acc Manag

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The debate on management reforms in the public health care sector has largely overlooked the role of human resource management (HRM) and its potential interaction with traditional management control (MC) mechanisms. This paper explores which factors associated with the integration between MC and HRM may foster organisational learning in a public health care setting. A case study in a public dental practice is used for examining this issue. Apart from highlighting the influence of various task characteristics, the case study suggests that the vertical as well as horizontal dimensions of integration are important to consider in this context. Implications for further research are discussed.

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Effects of New Control Systems in Swedish Health Care Organizations

Cited by 11 publications

References 12 publications

An institutional perspective on performance measurement and management in the ‘new public sector’

An institutional perspective on performance measurement and management in the ‘new public sector’

Have the Welfare Professions Lost Autonomy? A Comparative Study of Doctors and Teachers

Integrating Management Control and Human Resource Management in Public Health Care: Swedish Case Study Evidence

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