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Article
Publication date: 3 August 2010

Carolyn Cordery, Rachel Baskerville and Brenda Porter

This paper seeks to analyse accountability relationships developed since the introduction of reforms requiring nonprofit primary health organisations (PHOs) to discharge…

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Abstract

Purpose

This paper seeks to analyse accountability relationships developed since the introduction of reforms requiring nonprofit primary health organisations (PHOs) to discharge holistic accountability.

Design/methodology/approach

Case study data were obtained principally through semi‐structured interviews with PHOs and their key stakeholders, observation of formal and informal meetings, and primary and secondary documents.

Findings

While government strategy requires these PHOs to discharge holistic accountability, prior hierarchical‐based practices linger. A major impediment to securing holistic accountability is the failure of the new strategy to define clearly how the funder and provider should share accountability for improving their community's health. The implementation of holistic accountability was retarded when funders' propensity to control outcomes coincided with providers' lack of enthusiasm for embracing a greater range of stakeholders. The history and structure of individual PHOs was a key indicator of whether they discharged hierarchical or holistic accountability.

Research limitations/implications

This case study research is context‐specific and may have limited applicability to other PHOs or jurisdictions. However, the study shows that when funders and providers build trust rather than depending on control, holistic accountability relationships can be developed.

Practical implications

Despite government intention that primary health care relationships will lead to holistic accountability, this will not occur until funders clearly define responsibilities and trust their service providers.

Originality/value

There is a paucity of research into government‐sponsored holistic accountability relationships with local nonprofit service providers. This research provides a unique contextual analysis of the perspectives of funders, providers and a wide group of stakeholders and the operationalisation of two different styles of accountability.

Details

Accounting, Auditing & Accountability Journal, vol. 23 no. 6
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 19 February 2018

Jukka Pellinen, Toni Mättö, Kari Sippola and Antti Rautiainen

The purpose of this paper is to investigate how the complexity of the network governance setting affects accountability practices. The authors pay particular attention to…

Abstract

Purpose

The purpose of this paper is to investigate how the complexity of the network governance setting affects accountability practices. The authors pay particular attention to the organizational characteristics that may enable a common understanding of multiple accountability relationships, or lead to problems in reconciling competing forms of accountability, thereby appearing as blame game-type behavior.

Design/methodology/approach

The authors conducted a case study with 31 semi-structured interviews in a Finnish health care organization (FHC) that offers basic public health care services. The organization represents a co-operative arrangement with the main city and three smaller municipalities. The FHC has faced difficulties in balancing budget constraints with the provision of statutory care to citizens. This case is analyzed with the help of theories relating to accountability, the blame game, and dialogue.

Findings

The authors found that in the FHC operating under austerity constraints, attempts to reconcile financial, professional, and democratic accountability were made but, instead of dialogue and consensus, the different stakeholder groups resorted to defensive tactics in order to protect their resources, position, or sense of professional obligation. The authors suggest that in a context of network governance, accompanied by an increasing emphasis on financial accountability, organizational practices are susceptible to conflicting accountabilities and behavior characterized in this paper as a blame game.

Originality/value

The study contributes to the empirical studies on accountability in the new public governance context by analyzing the complex accountability relations between stakeholder groups with different agendas. The authors suggest organizational characteristics that may exacerbate conflicts between different stakeholder groups and prevent constructive dialogue. Furthermore, the study analyzes the composition of democratic accountability within the studied organization.

Details

Accounting, Auditing & Accountability Journal, vol. 31 no. 2
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 21 February 2022

Lee Parker and Venkateshwaran Narayanan

In the Covid-19 pandemic era, corporate responsibility and accountability for maintaining employee health and safety, particularly from this pernicious virus, have become…

Abstract

Purpose

In the Covid-19 pandemic era, corporate responsibility and accountability for maintaining employee health and safety, particularly from this pernicious virus, have become a matter of major social and economic importance. From an accountability through action perspective, this study aims to set out to evaluate the potential occupational health and safety accountability consequences of the Covid-19 pandemic.

Design/methodology/approach

This paper is based upon purposive sampling of several sets of publicly available data including published research literature addressing corporate social responsibility and accountability, and the literature more specifically addressing occupational health and safety (OHS) and its reporting. Also included are recent Web-based reports and articles concerning Covid-19-related OHS government and industry sponsored guidelines for employers and their workplaces across the UK and Australia.

Findings

The findings of this research highlight that firstly, the extant literature on OHS has been predominantly functionalist in its approach and that accountability through action provides an opportunity to make employers more visibly accountable for their response to Covid-19. Secondly, the paper highlights that despite recent progress on OHS issues significant concerns remained in the pre-Covid-19 era and that emerging regulations and legal obligations on employees have the potential to make OHS issues a prominent part of corporate social responsibility research.

Originality/value

Disease and mental health statistics reveal the potential significance of their expansion in the Covid-19 environment, and regulatory and legal liability concerns emerge as potential drivers of renewed corporate as well as researcher attention to OHS issues. Implications for the emergence of a broader range of accountability forms and visibilities are also canvassed.

Details

Meditari Accountancy Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2049-372X

Keywords

Article
Publication date: 1 October 2002

Mike Sheaff

Health and social services are being urged to establish clearer lines of accountability, while also developing innovative partnership working. For both goals to be…

Abstract

Health and social services are being urged to establish clearer lines of accountability, while also developing innovative partnership working. For both goals to be achieved, it is essential to move beyond the Government's highly centralised approach and recognise the scope for conflict between different accountability arrangements. The article uses practical examples to consider how this might be done.

Details

Journal of Integrated Care, vol. 10 no. 5
Type: Research Article
ISSN: 1476-9018

Keywords

Abstract

Details

Resilient Health Systems
Type: Book
ISBN: 978-1-80262-273-7

Article
Publication date: 1 December 1995

K.A. Van Peursem, M.J. Prat and S.R. Lawrence

A bewildering variety of performance measures and indicators inhealth management is evident in the literature and in practice. Reviewsmeasures useful for health management…

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Abstract

A bewildering variety of performance measures and indicators in health management is evident in the literature and in practice. Reviews measures useful for health management performance accountability, and expands on the traditional notion of health performance measures to incorporate nominal and ordinal measures. The research is performed in the interest of stimulating discussion in the public domain and with the intent of expanding current notions of the term “performance indicator”. Develops a comprehensive framework from measurement and accountability theory, and the medical management, accounting and accountability literatures are reviewed. Highlights the importance of using non‐ratio measures to capture outcomes, structure and processes influenced by management; and suggests that disclosures which include measures from all elements of the framework would most closely account for management activity.

Details

Accounting, Auditing & Accountability Journal, vol. 8 no. 5
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 11 March 2022

Irina Ibragimova

Global health challenges and threats could be confronted by collaborative efforts of international community. Governance for global health is a set of formal and informal…

Abstract

Purpose

Global health challenges and threats could be confronted by collaborative efforts of international community. Governance for global health is a set of formal and informal processes, operating beyond state boundaries, and refers to institutions and mechanisms established at the national, regional and international levels. Nordic countries demonstrated a long-standing commitment to development assistance for health (DAH), and more recently to governance for global health. Governance for global health tools could be used effectively to achieve collective solutions for the maintenance and promotion of health as a common good, could ensure accountability and transparency, and reconcile the interests of different actors on the international and national levels. The aim of this paper is to provide an overview of tools and approaches in support of eight sub-functions of governance for global health applied by the Nordic countries. This will help international audience to compare those mechanisms with similar mechanisms that are available or planned in their countries and regions, and may benefit policy scholars and practitioners.

Design/methodology/approach

This study uses qualitative review of research literature, policy documents and information available from institutional websites related to the governance of global health in four Nordic countries. In total, 50 selected publications were analyzed using framework synthesis, mapping all findings to 8 dimensions (sub-functions) of governance for global health and related tools.

Findings

Review reveals which tools are available, how they have been applied by the Nordic countries and influenced all domains (sub-functions) of governance for global health at different levels: national governments, agencies and networks; bilateral and multilateral partnerships; inter-governmental institutions and international health-related organizations. Common trends and approaches in governance for global health have been formulated.

Originality/value

This study is unique in relation to the prior literature as it looks at the role of Nordic countries in the governance for global health system through the lens of tools applied in support to its sub-functions.

Details

International Journal of Health Governance, vol. 27 no. 2
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 1 December 1997

S. Lawrence, M. Alam, D. Northcott and T. Lowe

Studies the transformation of social systems in health organizations in New Zealand and the way in which accounting systems are an integral part of the challenge to extant…

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Abstract

Studies the transformation of social systems in health organizations in New Zealand and the way in which accounting systems are an integral part of the challenge to extant structures of signification, legitimation and domination. By categorizing various modes or types of social change, and providing analytical means of clarifying social systems, Giddens’s structuration theory is enabling of empirical study. Accounting systems contribute to the binding of time and space in some circumstances, yet can play a part in major discontinuities and disruptions to institutionalized procedures and practices in other circumstances.

Details

Accounting, Auditing & Accountability Journal, vol. 10 no. 5
Type: Research Article
ISSN: 0951-3574

Keywords

Open Access
Article
Publication date: 24 June 2022

Jean Grugel, Sarah C. Masefield and Alan Msosa

Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do…

Abstract

Purpose

Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do EHPs deliver the human right to health for all? This study addresses this question through qualitative research into access to health care for vulnerable communities, using Malawi as a case study. This study shows that there are significant accountability gaps and perceptions of weak service provision in Malawi’s EHP in relation to some particularly marginalised (and stigmatised) groups that limit the right to health and the promise of “health for all”.

Design/methodology/approach

This study extends the body of qualitative work on EHPs in general and on Malawi in particular by exploring the perceptions of key stakeholders in relation to inclusivity and the delivery of health policies to particularly vulnerable groups. To do so, this study adopted an approach based on interpretive epistemologies (Scott, 2014). This study conducted largely unstructured interviews with a range of health stakeholders, speaking to stakeholders individually, rather than through focus groups due to the potentially sensitive nature of the topic.

Findings

The findings of this study are as follows: limited inclusion of civil society actors and local communities; local communities and local policymakers feel frustration with the gap between the promises of consultation in the EHP and the reality, and the difficulties of not having effective channels of communication; and exclusionary health practices for particularly vulnerable groups.

Research limitations/implications

There are limitations based on the qualitative methodology, and in terms of the particularly vulnerable groups – the authors studied two such groups (people with disabilities and those who identify as LBTQ) but a wider survey of vulnerable groups is needed to extend and confirm the findings.

Practical implications

Greater attention to the health rights of vulnerable groups would improve access and services, even in the context of resource restrictions. This study suggests that a deeper engagement with human rights-based approaches would pay dividends in terms of increasing access to health in Malawi, even within the constraints of the EHP process. Furthermore, without this, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

Social implications

Without addressing these issues, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

Originality/value

This paper makes an important contribution to the growing literatures on EHP in sub-Saharan Africa and Malawi in particular and to the importance of listening to stakeholder perceptions. It provides original data on stakeholder perspectives of the challenges associated with universalising health care in resource-constrained countries. To the best of the authors’ knowledge, it is one of the first papers to focus on the rights of disabled and LBTQ people in relation to EHPs.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

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Article
Publication date: 1 July 2001

Terry R. Lied

Hospitals are held increasingly accountable for the services they provide. While small hospitals may often lack resources to meet performance measurement mandates…

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Abstract

Hospitals are held increasingly accountable for the services they provide. While small hospitals may often lack resources to meet performance measurement mandates, generally, they are not exempt from requirements to submit performance data to accrediting and regulatory bodies. Presents an approach to obtaining, developing, and evaluating performance indicators that may be useful to small hospitals in meeting their mandates for public accountability and quality improvement. Takes into account resource limitations faced by these hospitals, both human and technological, and suggests a number of measures that are potentially useful for demonstrating accountability, benchmarking, and quality improvement.

Details

International Journal of Health Care Quality Assurance, vol. 14 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

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