Kenis Patrick
Department of Organisation Studies, Tilburg University, The Netherlands.
J Health Organ Manag. 2006;20(4):294-308. doi: 10.1108/14777260610680104.
To develop propositions on why public policies towards decreasing waiting list in health care can be expected to be unsuccessful.
DESIGN/METHODOLOGY/APPROACH: On the basis of a case study of public policies directed towards the reduction of the waiting lists in health care a number of propositions are formulated explaining why this policy has turned out to be ineffective. The propositions are based on theoretical insights form the field of organizations studies about the behavior of organizations and professionals.
It is demonstrated that public policies on reducing waiting lists in the Dutch health care system are likely to be ineffective because the policy-making strategies used are based on unrealistic assumptions about the behavior of organizations and professionals who are expected to reduce the waiting lists.
RESEARCH LIMITATIONS/IMPLICATIONS: Although the propositions are based on established organization literature, empirically they are only based on one case study.
In order to develop effective policy interventions it is important to be realistic about the behavior and strategies of the actors towards which the policy is directed. Moreover, rather than directing exclusive attention to those waiting, it is important for policy makers to address the interdependencies of the organizational field in which waiting lists occur.
ORIGINALITY/VALUE: This paper gives directions to policy makers who need to deal with complex and interdependent problems.
提出关于为何预期减少医疗保健等候名单的公共政策会不成功的命题。
设计/方法/途径:基于一项针对减少医疗保健等候名单的公共政策的案例研究,提出了一些命题,用以解释为何该政策被证明是无效的。这些命题基于组织研究领域中关于组织和专业人员行为的理论见解。
研究表明,荷兰医疗保健系统中减少等候名单的公共政策可能无效,因为所采用的决策策略基于对有望减少等候名单的组织和专业人员行为的不切实际假设。
研究局限/影响:尽管这些命题基于已有的组织文献,但从实证角度来看,它们仅基于一个案例研究。
为了制定有效的政策干预措施,重要的是要对政策所针对的行为者的行为和策略持现实态度。此外,政策制定者不应只专注于那些等待的人,而应对产生等候名单的组织领域的相互依存关系加以关注。
原创性/价值:本文为需要处理复杂且相互依存问题的政策制定者提供了指导。