NDLI: Do institutional logics predict interpretation of contract rules at the dental chair-side?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Harris, Rebecca Brown, Stephen Holt, Robin Perkins, Elizabeth
Spatial Coverage	England
Description	Author Affiliation: Harris R ( Institute Psychology, Health and Society, University of Liverpool, UK. Electronic address: harrisrv@liverpool.ac.uk.); Brown S ( Institute Psychology, Health and Society, University of Liverpool, UK.); Holt R ( School of Management, University of Liverpool, UK); Perkins E ( Institute Psychology, Health and Society, University of Liverpool, UK.)
Abstract	In quasi-markets, contracts find purchasers influencing health care providers, although problems exist where providers use personal bias and heuristics to respond to written agreements, tending towards the moral hazard of opportunism. Previous research on quasi-market contracts typically understands opportunism as fully rational, individual responses selecting maximally efficient outcomes from a set of possibilities. We take a more emotive and collective view of contracting, exploring the influence of institutional logics in relation to the opportunistic behaviour of dentists. Following earlier qualitative work where we identified four institutional logics in English general dental practice, and six dental contract areas where there was scope for opportunism; in 2013 we surveyed 924 dentists to investigate these logics and whether they had predictive purchase over dentists' chair-side behaviour. Factor analysis involving 300 responses identified four logics entwined in (often technical) behaviour: entrepreneurial commercialism, duty to staff and patients, managerialism, public good.
File Format	HTM / HTML
ISSN	02779536
e-ISSN	18735347
DOI	10.1016/j.socscimed.2014.10.020
Journal	Social Science & Medicine
Volume Number	122
Language	English
Publisher	Elsevier
Publisher Date	2014-12-01
Publisher Place	Great Britain (UK)
Access Restriction	Open
Subject Keyword	Discipline Medicine Contracts General Practice, Dental Logic National Health Programs Ethics Factor Analysis, Statistical Organization & Administration Insurance, Health, Reimbursement Qualitative Research Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Medicine Health (social science) History and Philosophy of Science

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