title: A Critique of Health System Performance Measurement.
abstract: Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are.
authors.affiliation: Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, University Avenue Calgary, Alberta, Canada tlynch9@me.com.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lynch
mesh_terms: D002017:Budgets; D002170:Canada; D003363:Cost Control; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D006291:Health Policy; D006293:Health Promotion; D006297:Health Services Accessibility; D006801:Humans; D017060:Patient Satisfaction; D019984:Quality Indicators, Health Care / Q000458:organization & administration*; D013222:State Medicine / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D014850:Waiting Lists
keywords: Alberta; Bourdieu; performance management