Management of mechanism design as an important way to improve public health

Open access

Abstract

One of the most important developments of modern economics is the concept of economic mechanism design. Mechanism design is the study of economic mechanisms that produce behaviors in public health. The concept has profound implications for management. Management involves the effective use of mechanisms to change behavior. Public health managers must have a strong background in sociology and psychology, negotiation, finance, economics, organizational theory, and leadership. All managers work with limited resources. Managers must understand finance and economics: budgets, investment in the Health Care system, accountability, investment return, optimization, and decision analysis. This feature creates unique challenges for educating and supporting public health managers. To advance public health management as a profession we must apply the basics of mechanism design to its challenges. Leadership science provides a base for development of managers’ personal skills and attributes. Many graduate programs in business management and public administration deal with public health management. Accordingly, application of mechanism design (economic, social and others) in public health management can help managers become more effective. Mechanism design in public health management could provide an important way to improve health of the population.

Introduction

Public health benefits come from better preparation and support for managers all over the world. Public health management involves a complex of challenges. It is important to understand and use classic or “first” principles to gain perspective about problems and see new solutions in difficult situations. Mechanism design processes apply classic or “first” principles to public health management challenges [1].

Results

Understanding of public health issues requires philosophical insight. Health care is unique. It is “public” for the reason. Private markets cannot allocate health care resources efficiently because competitive allocations require homogenous products, perfect information as well as free entry and exit from the markets. Health care must be provided as a public endeavor but it must be efficient as well [2]. This means that institutions of public health are a business and it is definitely a state enterprise. This feature creates unique challenges for educating and supporting public health managers. To advance public health management as a profession we must apply the basics of mechanism design to its challenges [3].

One of the most important developments of modern economics is the concept of economic mechanism design. In economics, mechanism design is the study of economic mechanisms that produce behaviors [4]. The concept has profound implications for management. At its core, management involves the effective use of mechanisms to change behavior. Accordingly, application of mechanism design (economic, social, and others) in public health management can help managers become more effective [5, 6, 7].

The main principles and mechanisms relate to universal management challenges: individual motivation and behavior, conflict and cooperation, allocation of resources, the way people work in groups and organizations, the meaning of system organization, resistance to change and personal attributes. Fundamental management mechanisms provide tools to deal with these challenges [8].

Motivating people requires state - of - the - art knowledge of psychology, sociology, and group dynamics. Groups and organizations require cooperative collective activity. Conflict in these settings is universal. Public health management requires negotiation skills and other techniques used to balance conflict and cooperation and use the tension for creative advantage [9].

All managers work with limited resources. Managers must understand finance and economics: budgets, accountability, return on investment, optimization and decision analysis. The “public” aspect of public health management emphasizes the political nature of management as a human endeavor. Effective public health management requires understanding of political processes and mechanisms [10].

Managers operate within constraints established by the system. Organizational theory helps explain how managers may operate more effectively within such constraints. It provides scientific underpinnings for describing why and how individuals resist change and how managers can deal with such resistance [11].

Management requires individual qualities such as character, perspective and leadership. Some of these require experience but aspects of it may be developed. Leadership science provides a base for development of managers’ personal skills and attributes [12, 13].

Universal challenges of public health management provide the basis for development and application of mechanisms to deal with such challenges. Public health managers must have a strong background in sociology and psychology, negotiation, finance, economics, organizational theory, and leadership. Many graduate programs in business management and public administration as well as in public health management require coursework in these areas, but very few programs include all of them [3,14].

Besides, many of these areas are neither particularly well developed nor have been rigorously applied to public health. Common agreement on core mechanisms for public health managers and structuring in the public health management around them might prompt social scientists and public health academics to focus their research on applying and extending these mechanisms in the public health arena. It makes most sense to explore a question of whether there is an optimal way to provide future public health managers with background experience in the form of internships, residencies or other career development that help enrich experience and perspective. Better understanding of the importance of the relative roles of personal attributes and education could help us structure the public health management better [14, 15].

Conclusion

All public health managers confront a set of universal problems. Identification and agreement about mechanisms that help managers deal with universal problems can help provide a basis for a universal approach to public health management education as well as extending our knowledge through research. Mechanism design in the public health management can provide an important way to improve health of the population.

Conflict of InterestConflict of Interest Statement None declared.

References

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    Foreman SA Kubyshkin AV Sukhareva IA. Comparative characteristic questions of Public Health managers in Ukraine and US. Tavricheskiy Mediko-Biologicheskiy Vestnik. 2008;4(11):7-11. Ukrainian.

  • 2

    Stolyarov SA Gossen IE. Management in Healthcare - actual component of modern management. Mod Probl Sci Educ [Internet]. 2015[cited 2018 Apr 5];5:11-17. Russian. Available from: http://www.science-education.ru/ru/article/view?id=22473

  • 3

    Negandhi P Negandhi H Tiwari R Sharma K Zodpey SP Quazi Z et al. Building interdisciplinary leadership skills among health practitioners in the 21st century: an innovative training model. Front Public Health. 2015;3:221.

  • 4

    Alexander JA Weiner BJ Griffi th J. Quality improvement and hospital financial performance. J Organ Behav. 2006;27:45-8.

  • 5

    Coyle-Shapiro JAM Kessler I Purcell J. Exploring organizationally directed citizenship behavior: Reciprocity or ‘It’s my Job’? J Manag Stud. 2004;41:56-61.

  • 6

    Mark AL. Notes from a small Island: researching organizational behavior in healthcare from a UK perspective. J Organ Behav. 2006;27(7):7-9. https://doi.org/10.1002/job.414

  • 7

    Rabarison KM Bish CL Massoudi MS Giles WH. Economic evaluation enhances public health decision making. Front Public Health. 2015;3:164. https://doi.org/10.3389/fpubh.2015.00164

  • 8

    Kuhlmann E Burau V Correia T Lewandowski R Lionis C Noordegraaf M et al. A manager in the minds of doctors: a comparison of new modes of control in European hospitals. BMC Health Serv Res. 2013;13:246. https://doi.org/10.1186/1472-6963-13-246

    • Crossref
    • Export Citation
  • 9

    Mansurov V Yurchenko O Allsop J Saks M. Anglo-American and Russian Sociology of Professions: Comparisons and Perspectives. Knowl Work Society (Sweden). 2004;2(2);341-9.

  • 10

    Nembhard IM Edmondson AC. Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J Organ Behav. 2006;27(7):941-66. https://doi.org/10.1002/job.413

    • Crossref
    • Export Citation
  • 11

    Vezyridis P. Technological Innovation and Change of Nursing Work in an Emergency Department. Med Sociol Online [Internet]. 2013[cited 2018 Apr 5];1(7). Available from: http://www.medicalsociologyonline.org/abstracts/abstracts.php?id=9030099653436148003

  • 12

    Earle S Letherby G eds. The Sociology of Healthcare: A Reader for Health Professionals. Basingstoke UK : Palgrave; 2008.

  • 13

    Pope С. Computers Cyborgs Webs and… medical sociology? Med Sociol Online [Internet]. 2014[cited 2018 Apr 5];1(8):96-101. Available from: http://www.medicalsociologyonline.org/Vol8Iss1/MSoVol8Iss1Art1/8.1_Art1.html

  • 14

    Baroff MB. My leadership engine. Front Public Health. 2015;3:137. https://doi.org/10.3389/fpubh.2015.00137

  • 15

    Yphantides N Escoboza S Macchione N. Leadership in public health: new competencies for the future. Front Public Health. 2015;3:24. https://doi.org/10.3389/fpubh.2015.00024

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  • 1

    Foreman SA Kubyshkin AV Sukhareva IA. Comparative characteristic questions of Public Health managers in Ukraine and US. Tavricheskiy Mediko-Biologicheskiy Vestnik. 2008;4(11):7-11. Ukrainian.

  • 2

    Stolyarov SA Gossen IE. Management in Healthcare - actual component of modern management. Mod Probl Sci Educ [Internet]. 2015[cited 2018 Apr 5];5:11-17. Russian. Available from: http://www.science-education.ru/ru/article/view?id=22473

  • 3

    Negandhi P Negandhi H Tiwari R Sharma K Zodpey SP Quazi Z et al. Building interdisciplinary leadership skills among health practitioners in the 21st century: an innovative training model. Front Public Health. 2015;3:221.

  • 4

    Alexander JA Weiner BJ Griffi th J. Quality improvement and hospital financial performance. J Organ Behav. 2006;27:45-8.

  • 5

    Coyle-Shapiro JAM Kessler I Purcell J. Exploring organizationally directed citizenship behavior: Reciprocity or ‘It’s my Job’? J Manag Stud. 2004;41:56-61.

  • 6

    Mark AL. Notes from a small Island: researching organizational behavior in healthcare from a UK perspective. J Organ Behav. 2006;27(7):7-9. https://doi.org/10.1002/job.414

  • 7

    Rabarison KM Bish CL Massoudi MS Giles WH. Economic evaluation enhances public health decision making. Front Public Health. 2015;3:164. https://doi.org/10.3389/fpubh.2015.00164

  • 8

    Kuhlmann E Burau V Correia T Lewandowski R Lionis C Noordegraaf M et al. A manager in the minds of doctors: a comparison of new modes of control in European hospitals. BMC Health Serv Res. 2013;13:246. https://doi.org/10.1186/1472-6963-13-246

    • Crossref
    • Export Citation
  • 9

    Mansurov V Yurchenko O Allsop J Saks M. Anglo-American and Russian Sociology of Professions: Comparisons and Perspectives. Knowl Work Society (Sweden). 2004;2(2);341-9.

  • 10

    Nembhard IM Edmondson AC. Making it safe: The effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teams. J Organ Behav. 2006;27(7):941-66. https://doi.org/10.1002/job.413

    • Crossref
    • Export Citation
  • 11

    Vezyridis P. Technological Innovation and Change of Nursing Work in an Emergency Department. Med Sociol Online [Internet]. 2013[cited 2018 Apr 5];1(7). Available from: http://www.medicalsociologyonline.org/abstracts/abstracts.php?id=9030099653436148003

  • 12

    Earle S Letherby G eds. The Sociology of Healthcare: A Reader for Health Professionals. Basingstoke UK : Palgrave; 2008.

  • 13

    Pope С. Computers Cyborgs Webs and… medical sociology? Med Sociol Online [Internet]. 2014[cited 2018 Apr 5];1(8):96-101. Available from: http://www.medicalsociologyonline.org/Vol8Iss1/MSoVol8Iss1Art1/8.1_Art1.html

  • 14

    Baroff MB. My leadership engine. Front Public Health. 2015;3:137. https://doi.org/10.3389/fpubh.2015.00137

  • 15

    Yphantides N Escoboza S Macchione N. Leadership in public health: new competencies for the future. Front Public Health. 2015;3:24. https://doi.org/10.3389/fpubh.2015.00024

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