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

Gwyn Bevan, Alice Evans and Sabina Nuti

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: 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.

JEL-codes: J50 (search for similar items in EconPapers)
Date: 2018-03-06
New Economics Papers: this item is included in nep-hea
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (6)

Published in Health Economics, Policy and Law, 6, March, 2018. ISSN: 1744-1331

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Persistent link: https://EconPapers.repec.org/RePEc:ehl:lserod:86469

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