Performance-based management (PBM) has become a dominant form
of governance in health care and there is a need for careful assessment of its
function and effects. This article contains a cross-disciplinary literature synthesis
of current studies of PBM. Literature was retrieved by database searches and
categorized according to analytical differences and similarities concerning
(1) purpose and (2) governance mechanism of PBM. The literature could
be grouped into three approaches to the study of PBM, which we termed:
the ‘functionalist’, the ‘interpretive’ and the ‘post-modern’ perspective. In the
functionalist perspective, PBM is perceived as a management tool aimed at
improving health care services by means of market-based mechanisms. In the
interpretive perspective, the adoption of PBM is understood as consequence
of institutional and individual agents striving for public legitimacy. In the
post-modern perspective, PBM is analysed as a form of governance, which has
become so ingrained in Western culture that health care professionals internalize
and understand their own behaviour and goals according to the values expressed
in these governance systems. The recognition of differences in analytical
perspectives allows appreciation of otherwise implicit assumptions and potential
implications of PBM. Re¿ections on such differences are important to ensure
vigilant appropriation of shifting management tools in health quality governance