Lynch Thomas
Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, University Avenue Calgary, Alberta, Canada
Int J Health Serv. 2015;45(4):743-61. doi: 10.1177/0020731415585987. Epub 2015 May 19.
Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are.
卫生系统绩效评估是一种普遍存在的现象。许多作者已经指出了绩效评估实践中存在的多个方法和实质问题。尽管这些批评是合理的且具有跨国性，但卫生系统绩效评估的实践仍在继续。西奥多·马尔莫尔认为，绩效评估引发了一种包裹在“语言混乱”中的“咒语式回应”。在本文中，我运用皮埃尔·布迪厄的理论框架扩展了马尔莫尔的见解，以表明马尔莫尔所指出的“语言混乱”远非一种异常现象，而是关于将公共卫生服务作为一种公共物品进行表征和分类的广泛斗争的一个指标。我呈现了一个来自加拿大艾伯塔省的绩效评估案例研究，考察这种表征斗争是如何发生的以及利害关系何在。
