New article from Simon Neby, Per Lægreid, Paola Mattei og Therese Feiler in European Policy Analysis
In the latest number of European Policy Analysis Per Lægreid together with Simon Neby from Uni Research Stein Rokkan Centre for Social Studies, Paola Mattei og Therese Feiler from Oxford University have published the article "Bending the Rules to Play the Game: Accountability, DRG and Waiting List Scandals in Norway and Germany".
Diagnosis Related Groups (DRGs) are used for financial and administrative
purposes in hospital systems across the world, and are combined with a series of
administrative tools to increase efficiency and effectiveness. Economic dysfunctions
of such systems are widely reported, but the organizational basis of this
managerial tool and the implications for hospital governance are less explored.
This article shows, through eight case studies, how DRGs and waiting list management
create opportunities for gaming in Norway and Germany. It argues
that whereas these effects are relatively similar, the way they are handled by different
accountability types varies considerably between Norway and Germany.
Despite similarities in gaming and accountability challenges in the single cases
studied, the Norwegian and German systems seem to cope with gaming in different
manners, as could be expected: The institutional context creates premises
for resolving such issues that vary more with the actual governance setting
than with the nature of a given case. Both systems are marked by a certain
ambiguity and complexity defined by reforms history, institutional dynamics,
and administrative traditions: the German legal-oriented, Bismarckian system
is as ambiguous as the Norwegian consensus-oriented Beveridge-type system.
Full version of the article are available here.