000			01850naa a2200193uu 4500
001			0051717510137
003			OSt
005			20190211171624.0
008			100517s2009 xx ||||gr |0|| 0 eng d
100	1		_aKELMAN, Steven _916996
245	1	0	_aPerformance improvement and performance dysfunction : _ban empirical examination of distortionary impacts of the emergency room wait-time target in the English National Health Service
260			_aCary : _bOxford University, _coct. 2009
520	3		_aThe literature on the use of performance measurement in government has focused much attention on hypothesized unintended dysfunctional consequences that such measurement may produce. We conceptualize these dysfunctional consequences as involving either effort substitution (reducing effort on nonmeasured performance dimensions) or gaming (making performance on the measured performance dimension appear better, when in fact it is not). In this paper, we examine both performance impacts and dysfunctional consequences of the establishment in the English National Health Service of a performance target that no patient presenting in a hospital accident and emergency department (emergency room) wait more than 4 hours for treatment. Using data from all 155 hospital trusts in England, we find dramatic wait-time performance improvements between 2003 and 2006 and no evidence for any of the dysfunctional effects that have been hypothesized in connection with this target. We conclude by discussing when one would expect dysfunctional effects to appear and when not
700	1		_aFRIEDMAN, John N _940139
773	0	8	_tJournal of Public Administration Research and Theory _g19, 4, p. 917-946 _dCary : Oxford University, oct. 2009 _xISSN 10531858 _w
942			_cS
998			_a20100517 _b1751^b _cDaiane
998			_a20120517 _b1357^b _cGeisneer
999			_aConvertido do Formato PHL _bPHL2MARC21 1.1 _c33177 _d33177
041			_aeng