Voice and Choice by Delegation

Bovenkamp, Hester van de; Vollaard, Hans; Trappenburg, Margo; Grit, Kor

doi:10.1215/03616878-1898803

Cited by 18 publications

(19 citation statements)

References 38 publications

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“…As we have noted above, in order to do so hospitals have to provide these actors with a lot of quality information. So far however, patients use quality information to choose their provider to a very limited extent ( Van de Bovenkamp et al., 2013 ). Insurers, who do ask for quality information from the hospitals, hardly use that data either: respondents feel that in practice insurers do not steer on quality but on price (see also Zuiderent-Jerak et al., 2010 ): They poor out this bureaucracy all over you and you have to comply with that.…”

Section: Resultsmentioning

confidence: 99%

Working with layers: The governance and regulation of healthcare quality in an institutionally layered system

Bovenkamp

Stoopendaal

Bal

2016

Public Policy and Administration

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Institutional arrangements used to steer public policies have increasingly become layered. Inspired by the literature on institutional layering and institutional work, this paper aims to make a contribution to our understanding of institutional layering. We do so by studying an interesting case of layering: the Dutch hospital sector. We focus on the actors responsible for the internal governance (Board of Directors and Supervisory Boards) and the external regulation (the Healthcare Inspectorate) of hospitals. In the paper, we explore the institutional work of these actors, more specifically how institutional work results from and is influenced by institutional layering and how this in turn influences the institutional makeup of both healthcare organizations and their institutional context. Our approach allowed us to see that layering changes the activities of actors in the public sector, can be used to strengthen one’s position but also presents actors with new struggles, which they in turn can try to overcome by relating and using the institutionally layered context. Layering and institutional work are therefore in continuous interaction. Combining institutional layering with a focus on the lived experiences of actors and their institutional work makes it possible to move into the layered arrangement and better understand its consequences.

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Section: Resultsmentioning

confidence: 99%

Working with layers: The governance and regulation of healthcare quality in an institutionally layered system

Bovenkamp

Stoopendaal

Bal

2016

Public Policy and Administration

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“…NPM, which is inspired by experiences and practices of the for-profit sector to improve the public sector (Hood 1995;Deem 1998) has the improvement of accountability and evaluation systems as one of its main operational implications (Talib 2003;Ferlie et al 2008;Pollitt 2009;Frølich and Caspersen 2015). In other words, the goal of NPM, also through the use of tools such as accreditation, is to combine the benefits of trade in terms of efficiency and consumer freedom with the benefits of the State in terms of solidarity and rights of access to services (Van de Bovenkamp et al 2013). In the context of HE, accreditation systems constitute, in particular, a tool aimed at assisting the transition from a state control model to a state supervisory model (Meek and Davies 2009).…”

Section: All That Glitters Is Not Gold: Shadows Of the Accreditation mentioning

confidence: 99%

Shadows over accreditation in higher education: some quantitative evidence

et al. 2019

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Shadows over accreditation in higher education: some quantitative evidenceAccreditation systems in Higher Education are widespread both in the US and in Europe. However, numerous reservations have appeared in the literature about whether these systems can comprehend and represent the quality of university courses. This study sets out to contribute to this debate by discussing whether the results of the recent university teaching accreditation system in Italy are influenced by the characteristics of degree programmes, their performance and the characteristics of incoming students. Whilst addressing this research question this paper intents above all to give a methodological contribution by proposing an evidence-based approach that tackles the limits found in the literature in relation to university accreditation and quality assurance

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“…Hirschman's framework of consumer strategies on a market is often applied, albeit slightly modified, in the analysis of user behaviour in so-called quasi markets where the main buyer (municipality) and the end user (the older user of home care services) are two different actors (Vamstad 2016). In this article, we will analyse how older users of Swedish home care services view and experience their possibilities for and actual use of ‘exit’, ‘choice’, ‘voice’ and ‘loyalty’ as strategies for choice and control (Greener 2008; Hirschman 1970; Van de Bovenkamp et al 2013). The ‘choice’ strategy may be available to older people as a means to get the services they want, and sometimes also a provider of their preference.…”

Section: Conceptual Framework For the Analysismentioning

confidence: 99%

Merely a rhetorical promise? Older users' opportunities for choice and control in Swedish individualised home care services

2017

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A policy shift has taken place in Sweden towards individualised elder-care and consumer choice. The aim of the study is to investigate how older users of home care services view and experience their opportunities of exerting influence and having choice and control in their everyday living, in terms of receiving preferred services that are flexible and responsive to their actual needs and priorities. The study was conducted in three local elder-care authorities, reflecting diverse present models of organising home care services in Sweden. Data consisted of responses to a postal survey (N = 2,792) and reports from qualitative interviews (N = 28) with older users. Our findings point to similarities rather than differences between the views and experiences of the users in the three participating local municipal elder-care authorities. A majority of users were positive about their home care services. The experiences ranged from being active and enabled to choose between providers and services, to being more or less passive dependants having to rely on the decisions of family and staff. The importance of supportive relationships, and interdependence between older people and their formal as well as informal support networks, became clear. Our findings may guide policy makers in refining home care services, irrespective of preferred model. In particular, efforts to facilitate staff continuity and prevent high staff turnover need to be prioritised.

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Voice and Choice by Delegation

Cited by 18 publications

References 38 publications

Working with layers: The governance and regulation of healthcare quality in an institutionally layered system

Working with layers: The governance and regulation of healthcare quality in an institutionally layered system

Shadows over accreditation in higher education: some quantitative evidence

Merely a rhetorical promise? Older users' opportunities for choice and control in Swedish individualised home care services

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