The administrative traditions in most Latin American countries are more prone to bureaucratic practices concerned in the documentary record of
normative procedures ("compliance") rather than the concrete outputs (or outcomes) of public hospitals as a result of appropriate public health policies.
This situation is mainly understood as one of the consequences of the Iberian colonization heritage, that set up the transmission of customs
of extensive bodies of elaborated written uniform laws and rules for governments in this world region (*).
In my opinion, these administrative practices are somewhat reluctant to introduce M&E (monitoring and evaluation) technics based on academic research work and quantitative-qualitative data collection.
At least for the argentine case, this situation can be verified from the observation of the quotidian work of the External Audit Institutions
-or SAI's- at a federal government level, as well as at subnational levels of government (Courts of Accounts, General Audits, etc.).
In contrast, countries whose public sectors are subject to "performance auditing" or "program evaluations" by their respectives SAI's -such as the Anglo-American administrative traditions or most OECD countries- have not only implemented "compliance audit" methods that verify legal compliance or financial statements, but also applies evaluation methods -supported by INTOSAI guidelines- that audit outcomes of public health policies (**).
(*) Painter, M. and Peters, G. "Tradition and Public Administration", Painter and Peters (Eds.) 2010. Palgrave MacMillan UK.
(**) Barzelay, M. "Central Auditing Institutions and Performance Auditing: A Comparative Analysis of Organizational Strategies in the OECD". Gov.: An Int. Journ. of Pol. and Adm., V.10, No.3, July 1997 (pp.235-260).
Hello Luís,
Cultural aspects such as law systems and its origins: roman law, or, on the other hand, common law, are very dificult issues to change. However, some assessment systems líke BSC, are beeing used all over the world, including in Portugal and Spain, in the field of public administration with succes. There are many examples of it, and also on management quality, benchmarking, and so on.
Elena, is very true what you say, BSC is a tool with great potential, especially to introduce or develop in the public sector.
Best regards
Dear Luis Federico Gimenez
Greetings,
Please find the attached file may be useful for you,
Best Regards
Yes, as long as reforms could be implemented at the lowest possible level.
I have been taken part of a three-year long research program on performance indicators in several hospitals in France. (Many Lat Am countries share with France a State-led healthcare system) - and our research suggests that centrally-chosen performance indicators (I mean decided at country-level for all hospitals) are helpful, but the degree of implementation can vary a lot across hospitals
Adrian: I agree, there is a trade-off between ease of implementation of KPIs to a hospital and the usefulness of a general policy of a system of KPI's (biases are reduced and comparability increases to reach a greater number of DMU's when they are centrally-chosen)
yes of course it can with condition of include rich thought and methods within of those articles and lead to inquiring modern conclusions and recommendations
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