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Effectiveness in political—administrative decision-making in specialized healthcare

Aim: To investigate the occurrence of the word ``effectiveness'' in the political—administrative decision-making minutes in specialized healthcare as presented to board and council meetings by top management teams. Methods: The occurrence and intended use of ``effectiveness'' were identified from all council and board meeting minutes (n = 190) of five Finnish university hospital districts in 2001 and 2006. Data were collected from the Internet pages of the hospital districts. For analysis, deductive content analysis combining qualitative and quantitative methodologies was used. Results: The word ``effectiveness'' occurred in the planning, organization and evaluation of service activities and in the definitions and justifications for the goal states of research and development work. Although objectives were justified by effectiveness, the occurrence and use of the term were not grounded on proven effectiveness but rather represented an ideal being pursued. Use of the word ``effectiveness'' increased from 2001 to 2006, particularly in the political—administrative decision-making of large hospital districts. This article gives useful information regarding the benefits of effectiveness in political—administrative decision-making. Conclusions: Healthcare is under pressure to increase effectiveness, which is manifested by rhetoric presentations of the term in the political—administrative decision-making in specialized healthcare. There is a need for focused collection and systematic follow-up of easily available effectiveness information in healthcare.