Gaming of performance measurement in health care: parallels with tax compliance

Gaming of performance measurement in health care distorts performance, making it appear better than it is. This can conceal potentially hazardous practice and endanger patients and staff. Research has investigated and categorized this behaviour but as yet has offered little in the way of potential s...

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Bibliographic Details
Published inJournal of health services research & policy Vol. 15; no. 4; p. 236
Main Authors Mears, Alex, Webley, Paul
Format Journal Article
LanguageEnglish
Published England 01.10.2010
Subjects
Clinical Competence
Delivery of Health Care - standards
England
Health Policy
Humans
Morals
Quality Indicators, Health Care
State Medicine
Taxes - legislation & jurisprudence
England
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Summary:Gaming of performance measurement in health care distorts performance, making it appear better than it is. This can conceal potentially hazardous practice and endanger patients and staff. Research has investigated and categorized this behaviour but as yet has offered little in the way of potential solutions as the drivers are still not well understood. Studies of the psychology of tax behaviour, specifically tax avoidance and evasion, reveal some insights into what the underlying causes are. Looking at health care and tax compliance, seven similarities in response can be detected: negative view of those subject to it; not salient except for specific classes of people; general understanding of the need versus resentment of actuality; cognitive dissonance; moral versus legal grey areas; two levels of objective non-compliance; and four categories of subjective behaviour and attitude. We suggest a model of reaction and compliance for gaming and offer some suggestions as to how this phenomenon might be minimized.
ISSN:1758-1060
DOI:10.1258/jhsrp.2010.009074