This chapter considers how government can influence the organization of the health-care delivery system. It begins by defining the meaning of “an organization”—as a provider of health-care services—and that of “the organization of the system.” It then describes three kinds of interventions: changes in who-does-what, changes in incentives, and managerial changes, and discusses how they can improve overall performance. These interventions must work together; incentive changes like decentralization or contracting will not alter outcomes unless accompanied by changes at the managerial level. Similarly, the potential cost savings and clinical quality gains from changing scale and scope will only be realized if managers take advantage of their opportunities. Ultimately, the behavior of front-line workers and their managers has to be changed to produce real improvement.
Oxford Scholarship Online requires a subscription or purchase to access the full text of books within the service. Public users can however freely search the site and view the abstracts and keywords for each book and chapter.
If you think you should have access to this title, please contact your librarian.