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Competing logics in a hybrid organization: ICT service provision in the Italian health care sector

Laura Maran (Department of Accounting, RMIT University, Melbourne, Australia)
Alan Lowe (Department of Accounting, RMIT University, Melbourne, Australia)

Accounting, Auditing & Accountability Journal

ISSN: 0951-3574

Article publication date: 30 April 2021

Issue publication date: 9 March 2022

746

Abstract

Purpose

This paper reports an investigation of a hybrid ex-state-owned enterprise (ex-SOE) providing ICT (Information and Communication Technology) services in the Italian healthcare sector (in-house provision). The authors aim to offer a framing that reflects the concerns expressed in the interdisciplinary literature on hybrid SOEs from management, public administration and, more recently, accounting.

Design/methodology/approach

This study operationalizes Besharov and Smith’s (2014) theoretical model on multiple logics to analyze institutional structures and organizational outcomes at an ICT in-house provider. It builds on extensive textual analysis of regulatory, archival, survey and interview data.

Findings

The study results show that the combination of hybridity in the form of layering of multiple logics in the health care sector (Polzer et al., 2016) creates problems for the effectiveness of ICT provision. In particular, the hybrid organization the authors study remained stuck in established competing relationships despite a restructure of regional health care governance. The study findings also reflect on the design of organizational control mechanisms when balancing different logics.

Research limitations/implications

The identified case-study accountability practices and performance system add to the debate on hybrid organizations in the case of ex-SOEs and facilitate the understanding and management of hybrids in the public sector. The authors note policymaking implications.

Originality/value

The authors’ operationalization of Besharov and Smith's (2014) model adds clarity to key elements of their model, notably how to identify evidence in order to disentangle notions of centrality and compatibility. By doing this, the authors’ analysis offers potential insights into both managerial design and policy prescription. The authors provide cautionary tales around institutional reorganization regarding the layered synthesis of logics within these organizations.

Keywords

Acknowledgements

The authors express their appreciation for the continuous encouragement and support of the Guest Editors of this Special Issue, in particular Prof. Giuseppe Grossi and Prof. Massimo Sargiacomo. The authors wish to thank two anonymous reviewers who provided critical assessments on the paper. The authors would also like to acknowledge the comments received during the presentation of earlier versions of this paper at the 2017 Critical Perspectives on Accounting Conference, held in Québec city (Canada) and in the 2021 University of Essex research seminar series. In addition, they acknowledge the support of Professors Laura Ramaciotti (University of Ferrara) and Patrizio Bianchi (Italian Ministry of Education) for involving one of the authors in a research project that inspired this work.

Citation

Maran, L. and Lowe, A. (2022), "Competing logics in a hybrid organization: ICT service provision in the Italian health care sector", Accounting, Auditing & Accountability Journal, Vol. 35 No. 3, pp. 770-800. https://doi.org/10.1108/AAAJ-12-2019-4334

Publisher

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Emerald Publishing Limited

Copyright © 2021, Emerald Publishing Limited

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