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Reputations count: why benchmarking performance is improving health care across the world

Bevan, Gwyn ORCID: 0000-0003-2123-3770, Evans, Alice and Nuti, Sabina (2018) Reputations count: why benchmarking performance is improving health care across the world. Health Economics, Policy and Law. ISSN 1744-1331

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Identification Number: 10.1017/S1744133117000561


This paper explores what motivates improved health care governance. Previously, many have thought that performance would either improve via choice and competition or relying on trust and altruism. But neither assumption is supported by available evidence. So instead we explore a third approach of reciprocal altruism with sanctions for unacceptably poor performance and rewards for high performance. These rewards and sanctions, however, are not monetary but in the form of reputational effects through public reporting of benchmarking of performance . Drawing on natural experiments in Italy and the UK, we illustrate how public benchmarking can improve poor performance at both the sub-national and national level through ‘naming and shaming’ and enhance good performance through ‘competitive benchmarking’ and peer learning. Ethnographic research in Zambia also showed how reputations count. Policy-makers could use these effects in different ways to improve public services.

Item Type: Article
Official URL:
Additional Information: © 2017 Cambridge University Press
Divisions: Management
Subjects: H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
R Medicine > RA Public aspects of medicine
Date Deposited: 17 Jan 2018 09:32
Last Modified: 06 Jul 2024 00:48

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