IMPLEMENTING PERFORMANCE‐BASED FUNDING FOR HEALTH RESEARCH: WHEN GOVERNANCE AND PROCEDURAL FAIRNESS MATTER
研究了意大利卫生部对IRCCS医院实施基于绩效的研究资助十年后的效果，发现系统虽持续但执行偏离初衷，程序不公和政治领导缺失破坏了医院与卫生部间的信任。
The article examines the implementation by the Italian Ministry of Health of performance‐based funding to allocate resources for research to IRCCS ( Istituti di Ricovero e Cura a Carattere Scientifico ) hospitals. The analysis provides evidence that ten years from its introduction the performance‐based funding system has persisted, but it has been implemented rather differently from what had been imagined by its proponents. By drawing on the theoretical frameworks of policy implementation, agency, and relational contracting, the study establishes that the overall design of the system has contributed to this final outcome only to a limited extent. Rather, the lack of procedural fairness, as well as of political leadership in linking the system to national research priorities, has undermined the basis for trust between hospitals and the Ministry of Health. The article discusses how, in this, the governance of performance‐based funding and its strong ownership by the ministerial bureaucracy has been determinant.