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In: Community development journal, Volume 31, Issue 3, p. 273-274
ISSN: 1468-2656
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In: Community development journal, Volume 31, Issue 3, p. 273-274
ISSN: 1468-2656
In: Indian defence review, Volume 31, Issue 2, p. 51-58
ISSN: 0970-2512
World Affairs Online
In: Defence science journal: DSJ, Volume 59, Issue 4, p. 436-440
ISSN: 0011-748X
In: Social policy & administration: an international journal of policy and research, Volume 36, Issue 7, p. 780-795
ISSN: 0037-7643, 0144-5596
In: Defence science journal: DSJ, Volume 60, Issue 2, p. 137-151
ISSN: 0011-748X
In: Defence science journal: DSJ, Volume 44, Issue 4, p. 269-278
ISSN: 0011-748X
In: Defence science journal: DSJ, Volume 39, Issue 1, p. 99-107
ISSN: 0011-748X
In: Defence science journal: a journal devotet to science & technology in defence, Volume 60, Issue 2, p. 137-152
ISSN: 0011-748X
In: Defence science journal: DSJ, Volume 43, Issue 3, p. 269-273
ISSN: 0011-748X
In: Defence science journal: DSJ, Volume 42, Issue 3, p. 201-204
ISSN: 0011-748X
In: Defence science journal: DSJ, Volume 41, Issue 4, p. 357-362
ISSN: 0011-748X
Background and Objectives: Neoliberal 'reform' has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. This paper examines the relationships between ownership, organisational structure and managerial regime within an elaboration of Donabedian's reasoning about organisational structures. Using new data from England it considers: 1. How do the internal managerial g regimes of differently owned healthcare providers differ, or not? 2. In what respects did any such differences arise from differences in ownership or for other reasons? Methods: An observational systematic qualitative comparison of differently-owned providers was the strongest feasible research design. We systematically compared a maximum-variety sample (by ownership) of community health services (CHS); out-of-hours primary care (OOH); hospital planned orthopaedics and ophthalmology providers (N=12 cases). The framework of comparison was the ownership theory mentioned above. Findings: The relationships between ownership (one one hand) and organisation structures and managerial regimes (on the other), differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations the doctors', but not other occupations', work was controlled and coordinated in a more-or-less democratic, self-governing ways. Conclusion: Ownership does make important differences to healthcare providers' top-level governance structures and accountabilities; and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use of power within them, and system-wide policy interventions, for instance to improve care coordination; and for the correspondingly required foci of healthcare organisational research.
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In: Defence science journal: DSJ, Volume 56, Issue 4, p. 551-557
ISSN: 0011-748X
In: Defence science journal: DSJ, Volume 52, Issue 2, p. 147-156
ISSN: 0011-748X