Is there really nothing so practical as a good theory?

Background: In the context of serious concerns over the affordability of healthcare, various authors and international policy bodies advise that strategic purchasing is a key means of improving health system performance. Such advice is typically informed by theories from the economics of organization (EOO). This paper proposes that these theories are insufficient for a full understanding of strategic purchasing in healthcare, because they focus on safeguarding against poor performance and ignore the coordination and adaptation needed to improve performance. We suggest that insights from other, complementary theories are needed. Methods: A realist review method was adopted involving 3 steps: first, drawing upon complementary theories from the EOO and inter-organizational relationships (IOR) perspectives, a theoretical interpretation framework was developed to guide the review; second, a purposive search of scholarly databases to find relevant literature addressing healthcare purchasing; and third, qualitative analysis of the selected texts and thematic synthesis of the results focusing on lessons relevant to 3 key policy objectives taken from the international health policy literature. Texts were included if they provided relevant empirical data and met specified standards of rigour and robustness. Results: A total of 58 texts were included in the final analysis. Lessons for patient empowerment included: the need for clearly defined rights for patients and responsibilities for purchasers, and for these to be enacted through regular patientpurchaser interaction. Lessons for government stewardship included: the need for health strategy to contain specific targets to incentivise purchasers to align with national policy objectives, and for national government actors to build close, trusting relationships with purchasers to facilitate access to local knowledge about needs and priorities. Lessons for provider performance included: provider decision autonomy may drive innovation and efficient resource use, but may also create scope for opportunism, and interdependence likely to be the best power structure to incentivise collaboration needed to drive performance improvement. Conclusion: Using complementary theories suggests a range of general policy lessons for strategic purchasing in healthcare, but further empirical work is needed to explore how far these lessons are a practically useful guide to policy in a variety of healthcare systems, country settings and purchasing process phases.

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“…14 Moreover, theories are intensely practical and should be used by practitioners as guidance in deciding what to do and how to do it. 15…”

Section: Introductionmentioning

confidence: 99%

What’s Needed to Develop Strategic Purchasing in Healthcare? Policy Lessons from a Realist Review

Sanderson

Lonsdale

Mannion

2018

Int J Health Policy Manag

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“…Toward this end, our article draws on a set of well-established theoretical perspectives to articulate what they can offer about sustainability for marketing researchers. Relying on theories that have demonstrated their usefulness for explaining organizational actions should instill a measure of confidence in the insights derived from them (Lundberg 2004).…”

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confidence: 99%

Toward a “theoretical toolbox” for sustainability research in marketing

Connelly

Ketchen

Slater

2010

J. of the Acad. Mark. Sci.

321

226

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This paper provides a foundation for future marketing research on sustainability through the application of nine prominent organizational theories. Specifically, we consider the implications for sustainability offered by transaction cost economics, agency theory, institutional theory, population ecology, resource dependence theory, the resource-based view of the firm, upper echelons theory, social network theory, and signaling theory. We consider how each theory can help researchers to better understand the ways that firms engage in sustainable marketing and business practices, and we develop insights that emerge from simultaneous examination of complementary or competing theoretical perspectives.

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“…We hope the DCB idea will provoke thought and dialogue about this consequential form of organizational behaviour (cf. Lundberg, 2004).…”

Section: Discussionmentioning

confidence: 99%

Detrimental Citizenship Behaviour: A Multilevel Framework of Antecedents and Consequences

Pierce

Aguinis

2015

Manag. Organ. Rev.

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There is regular and explicit media coverage of employee behaviour intended to advance organizational goals, but that harms stakeholder interests in ways that exceed necessity and reason. Although several constructs such as workplace deviance, organizational misbehaviour, corporate crime and corruption, and unethical pro-organizational behaviour have been advanced to account for this type of behaviour, no comprehensive framework exists that also includes the full scope of its important consequences. Accordingly, we propose the umbrella construct of detrimental citizenship behaviour (DCB) that allows us to integrate and build upon previous related conceptualizations that have developed mostly in parallel bodies of research. We rely on ethical decision-making, creativity, and instrumental stakeholder theories to embed the umbrella DCB construct within a multi-level and longitudinal model. The DCB model includes processes through which such behaviour and its consequences unfold over time for organizational members, organizations, and society at large. The proposed framework describes, explains, and predicts DCB and also leads to suggestions for future research. In addition, we offer suggestions regarding how to manage this highly consequential type of organizational behaviour, thereby engaging in a much-needed science-practice dialogue in management and organization studies.

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Is there really nothing so practical as a good theory?

Cited by 19 publications

References 2 publications

What’s Needed to Develop Strategic Purchasing in Healthcare? Policy Lessons from a Realist Review

What’s Needed to Develop Strategic Purchasing in Healthcare? Policy Lessons from a Realist Review

Toward a “theoretical toolbox” for sustainability research in marketing

Detrimental Citizenship Behaviour: A Multilevel Framework of Antecedents and Consequences

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