Abstract

Recent work in representative bureaucracy focuses on the micro-foundations of representation and explores the conditions for who represents and who receives representation. Drawing on insights from street-level bureaucracy, this article contributes to the micro theory of representation by exploring how workload influences the ability for a bureaucrat to represent a client. Extant literature highlights how bureaucrats’ resort to coping mechanisms to deal with conflicting demands and work requirements, yet how these mechanisms guide representation have yet to be explored. Findings from over 35,000 cases in Florida hospital emergency room departments reveal that physician-patient gender matching predicts a significant decrease in heart attack mortality when physician workload is normal. Moreover, the effects of representation are amplified when workload is low. When workload is high, however, there is no substantive benefit associated with representation. These findings suggest that representation is a discretionary action affected by workload and can carry distributional consequences depending on how bureaucrats’ cope with job stress.

摘要

代议制官僚机构最近的工作侧重于代表的微观基础，并探讨了谁代表和谁获得代表的条件。本文借鉴街头官僚机构的见解，通过探讨工作量如何影响官僚代表客户的能力，为微观的代表理论做出了贡献。现有文献强调官僚如何诉诸应对机制来处理相互冲突的需求和工作要求，但这些机制如何指导代表仍有待探索。佛罗里达州医院急诊室超过 35,000 例病例的研究结果表明，当医生工作量正常时，医患性别匹配可预测心脏病发作死亡率显着降低。而且，当工作量低时，代表的影响会被放大。然而，当工作量很大时，代表没有实质性的好处。这些发现表明，代表权是一种受工作量影响的自由裁量行为，并且可以根据官僚应对工作压力的方式产生分配后果。