Health-care management and the culture of assessment: An urgent liaison?

Effectiveness in health-care management has been defined as the relationship between what a manager achieves in terms of performance and what he or she is expected to achieve; that is, effectiveness is the extent to and means by which an organization carries out its defined functions (6). The implicit, albeit core functions of hospitals and primary care centers in providing patient access, professional and center responsiveness, effective and safe services, and improved health outcomes, have increasingly been blurred by other more explicit objectives, such as cost-containment and process reengineering. Indiscriminate cost-cutting and “reengineering mania” have become popular among health-care policy-makers all over the world. Such strategies have even been adopted by countries (including Spain) whose health-care expenditures have for decades ranked below the European average (9). However, the effects of these widespread trends have never been properly assessed. They seem to impose a common threat on professional job satisfaction, and in Europe, there are more impatient patients on the waiting list than ever (8)