IMPLEMENTING PERFORMANCE-BASED FUNDING FOR HEALTH RESEARCH: WHEN GOVERNANCE AND PROCEDURAL FAIRNESS MATTER
IMPLEMENTING PERFORMANCE-BASED FUNDING FOR HEALTH RESEARCH: WHEN GOVERNANCE AND PROCEDURAL FAIRNESS MATTER
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DOI：
10.1111/j.1467-9299.2011.01965.x
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发表时间：
2012-01-01
影响因子：
3.5
通讯作者：
Tediosi, Fabrizio
中科院分区：
文献类型：
--
作者：
Compagni, Amelia;Tediosi, Fabrizio
这篇文章审查了意大利卫生部实施的基于绩效的供资，将研究资源分配给IRCCS （instituti di Ricovero e Cura a caratere Scientifico）医院的情况。分析提供的证据表明，基于绩效的资助制度在引入十年后仍然存在，但它的实施与支持者想象的大不相同。通过借鉴政策实施、代理和关系契约的理论框架，该研究确立了制度的总体设计对这一最终结果的贡献仅在有限的程度上。相反，缺乏程序公平，以及在将该系统与国家研究重点联系起来方面缺乏政治领导，已经破坏了医院与卫生部之间信任的基础。本文讨论了在这种情况下，基于绩效的资金管理及其由部长级官僚机构的强大所有权是如何起决定作用的。
The article examines the implementation by the Italian Ministry of Health of performance-based funding to allocate resources for research to IRCCS (Istituti di Ricovero e Cura a Carattere Scientifico) hospitals. The analysis provides evidence that ten years from its introduction the performance-based funding system has persisted, but it has been implemented rather differently from what had been imagined by its proponents. By drawing on the theoretical frameworks of policy implementation, agency, and relational contracting, the study establishes that the overall design of the system has contributed to this final outcome only to a limited extent. Rather, the lack of procedural fairness, as well as of political leadership in linking the system to national research priorities, has undermined the basis for trust between hospitals and the Ministry of Health. The article discusses how, in this, the governance of performance-based funding and its strong ownership by the ministerial bureaucracy has been determinant.