Systems ideologies and street-level bureaucrats: Policy change and perceptions of quality in a behavioral health care system

• 成果类型: Article
• 署名作者: Isett, KR; Morrissey, JP; Topping, S
• 署名单位: Columbia University; University of North Carolina; University of North Carolina Chapel Hill; University of North Carolina; University of North Carolina Chapel Hill; University of Southern Mississippi
• 刊物名称: PUBLIC ADMINISTRATION REVIEW
• ISSN/ISSBN: 0033-3352
• DOI: 10.1111/j.1540-6210.2006.00574.x
• 发表日期: 2006
• 页码: 217-227
• 关键词: managed care; MENTAL-HEALTH; job-satisfaction; maintenance organization; physician satisfaction; HMO; performance; penetration; dimensions; illness

摘要

This article examines the stability of street-level bureaucrats' negative perceptions regarding a newly implemented managed care system on quality of care and service delivery in a publicly funded behavioral health care system. Overall findings indicate that the generally negative perception of managed care did not differ between staff in the two programs, indicating a weak effect on attitudes of frontline workers. More proximal variables to the caregiver, such as service type and job title, show more influence on attitudes. The conclusion discusses the implications of these findings for practicing administrators and academic researchers.