Creating and accounting for value-based management of hospital services

Creating and accounting for value-based management of hospital servicesPeter Triantafillou Dept. of Social Science and Business, Roskilde University, Denmark, Email: triant@ruc.dm Abstract for the IRSPM Conference,... [ view full abstract ]

Creating and accounting for value-based management of hospital services

Peter Triantafillou

Dept. of Social Science and Business, Roskilde University, Denmark, Email: triant@ruc.dm

Abstract for the IRSPM Conference, Edinburgh, 11^th – 13^th April 2018.

Panel: Accounting and Accountability of value creation in innovative public service delivery arrangements.

Purpose: Value-based management of hospital services has recently spread to a number of liberal democracies. However, value-based management has had a very hard time gauging the clinical outcomes of health interventions and, therefore, it has been very difficult to gauge the value of these interventions. The paper seeks to understand why we find substantial medical and political support for adopting value-based management in healthcare.

Design/methodology/approach: Inspired by French philosopher Michel Foucault, this paper explores the said question by employing the analytical concept of government assemblage in the context of the attempts to implement value-based management in Danish hospital services. It relies mainly on document studies.

Findings: Value-based management is medically attractive because it promises to provide a solution to the problem of causality by recasting this problem from an objectivist clinical approach to a subjectivist patient one. Secondly, this subjectivist approach to gauging health outcomes seems to induce political support because it resonates well with wider rationalities of government favouring citizen empowerment and participation.

Orginality/value: The study provides an understanding of the emergence and support of value-based management in healthcare that goes beyond both institutionalist approaches (emphasising isomorphic pressures) and Actor Network Theories (emphasising the technical dimension of assemblages) by paying attention to the political power and rationalities at stake in value-based management.