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Article
Publication date: 1 June 2002

Nas Ahadiat

US health care services will be among the top ten occupations with the fastest growth over the next decade with total employment in health care services expected to increase by 19…

Abstract

US health care services will be among the top ten occupations with the fastest growth over the next decade with total employment in health care services expected to increase by 19 million by the year 2006. As the market continues to expand, demand for graduates is likely to shift from the traditional areas of employment, to more industry‐related jobs. Recruiters will focus their attention on hiring graduates as accountability, cost containment, profitability, and reporting of health care services become increasingly critical for health care providers competing for the national health care dollars. A study was conducted to determine what knowledge, skills, and attributes (KSAs) are most important for an accounting career in health care organizations. The investigation resulted in identification of 25 most important KSAs. Further analysis revealed that the KSAs identified herein are somewhat at odds with those found by other researchers for employment in other segments, e.g. public accounting.

Details

Career Development International, vol. 7 no. 3
Type: Research Article
ISSN: 1362-0436

Keywords

Article
Publication date: 24 February 2022

Gillian Vesty, Olga Kokshagina, Miia Jansson, France Cheong and Kerryn Butler-Henderson

Despite major progress made in improving the health and well-being of millions of people, more efforts are needed for investment in 21st century health care. However, public…

Abstract

Purpose

Despite major progress made in improving the health and well-being of millions of people, more efforts are needed for investment in 21st century health care. However, public hospital waiting lists continue to grow. At the same time, there has been increased investment in e-health and digital interventions to enhance population health and reduce hospital admissions. The purpose of this study is to highlight the accounting challenges associated with measuring, investing and accounting for value in this setting. The authors argue that this requires more nuanced performance metrics that effect a shift from a technical practice to one that embraces social and moral values.

Design/methodology/approach

This research is based on field interviews held with clinicians, accountants and administrators in public hospitals throughout Australia and Europe. The field research and multidisciplinary narratives offer insights and issues relating to value and valuing and managing digital health investment decisions for the post-COVID-19 “value-based health-care” future of accounting in the hospital setting.

Findings

The authors find that the complex activity-based hospital funding models operate as a black box, with limited clinician understanding and hybridised accounting expertise for informed social, moral and ethical decision-making. While there is malleability of the health economics-derived activity-based hospital funding models, value contestation and conflict are evident in the operationalisation of these models in practice. Activity-based funding (ABF) mechanisms reward patient throughput volumes in hospitals but at the same time stymie investment in digital health. Although classified as strategic investments, there is a limit to strategic planning.

Research limitations/implications

Accounting in public hospitals has become increasingly visible and contested during the pandemic-driven health-care crisis. Further research is required to examine the hybridising accounting expertise as it is increasingly implicated in the incremental changes to ABF in the emergence of value-based health care and associated digital health investment strategies. Despite operationalising these health economic models in practice, accountants are currently being blamed for dysfunctional health-care decisions. Further education for practicing accountants is required to effect operational change. This includes education on the significant moral and ethical dilemmas that result from accounting for patient mix choices in public hospital service provision.

Originality/value

This research involved a multidisciplinary team from accounting, digital health, information systems, value-based health care and clinical expertise. Unique insights on the move to digital health care are provided. This study contributes to policy development and the limited value-based health-care literature in accounting.

Details

Meditari Accountancy Research, vol. 31 no. 1
Type: Research Article
ISSN: 2049-372X

Keywords

Article
Publication date: 1 September 1994

Wai Fong Chua and Alistair Preston

Aims to promote concern and debate about the penetration of accountingand financial management in the health care sectors of severalAnglo‐Saxon countries – the United States…

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Abstract

Aims to promote concern and debate about the penetration of accounting and financial management in the health care sectors of several Anglo‐Saxon countries – the United States, United Kingdom and New Zealand. Questions may be raised in several ways. For example, by highlighting how accounting concepts such as “costs” are not neutral notions but rather are sites for struggles of divergent interests or by commenting on how accounting may change or be changed by different organizational and societal rationalities. Concern may also be raised by questioning the effects of accounting change in terms wider than the purely instrumental and thereby arguing that its global spread is grounded more in faith than “factual” evidence regarding its efficacy.

Details

Accounting, Auditing & Accountability Journal, vol. 7 no. 3
Type: Research Article
ISSN: 0951-3574

Keywords

Open Access
Article
Publication date: 3 August 2021

Antti Rautiainen, Toni Mättö, Kari Sippola and Jukka O. Pellinen

This article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.

2012

Abstract

Purpose

This article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.

Design/methodology/approach

In contrast to the majority of earlier studies focusing on special health care, the study was conducted in a Finnish basic health care organization. The empirical data include 36 interviews, accounting reports, budgets, newspaper articles and meeting notes collected 2013–2018.

Findings

The use of accounting techniques in this case did not offer professionals sufficient support under conditions of conflict. The authors suggest that this perceived lack of support intensified the negative emotions toward accounting techniques. These negative emotions aggregated into incompatible professional-level institutional logics, which contributed to the lack of hybridization between such logics. The authors highlight the importance of the cognitive microfoundations, that is, the individual-level interpretations and emotional responses, in the analysis of conflicting institutional logics.

Practical implications

Managerial attention needs to be directed to accounting practices perceived as frustrating or threatening, a perception that can prevent the use of accounting techniques in the creation of professional hybrids. The Finnish basic health care context involves inconsistent political decision-making, multiple tasks, three institutional logics and individual interpretations and emotions in various decision-making situations.

Originality/value

This study develops microfoundational accounting research by illustrating how individual-level cognitive microfoundations such as dissatisfaction with budgeting, aggregate into professional-level institutional logics, and in our case, prevent professional hybridization in a basic health care setting characterized by conflict and three separate institutional logics.

Details

Accounting, Auditing & Accountability Journal, vol. 35 no. 3
Type: Research Article
ISSN: 0951-3574

Keywords

Article
Publication date: 1 March 2005

Rute Abreu, Fátima David and David Crowther

Health care is an essential need of the society and it is an integral part thereof. In this sense, everybody is entitled to medical services to provide health and well‐being that…

Abstract

Health care is an essential need of the society and it is an integral part thereof. In this sense, everybody is entitled to medical services to provide health and well‐being that improves lifestyle. Policymakers and researchers focus substantial attention on hospitals and public spending of financial resources, because they recognise the political power and the general collective obligation of preserving a health care for the present and future generations. The empirical analysis used a sample based in the 31 corporate hospitals that belong to the Portuguese health care system as a National Health Service in the period 2002–2003. The disclosure of information allows comparability and identifies similarities between the hospitals in the sample. Relevant organizational variables were managed statistically through the multivariate analysis. The geographical analysis shows inequalities of the distribution of hospitals facilities in Portugal, with marked concentration in the urban coastal areas, affected by the number of persons that live there. The financial analysis is supported in the Portuguese Official Accounting Plan that follows the same accounting trend of corporations. So, the disclosure and the accountability system are not opened up to a new field for accounting in health care based in the Health Official Accounting Plan. The research shows implications at the operational level, the efficiency and the effectiveness of the health care strategy with differences between hospitals. The authors believe that, as complex organizations, hospitals must based their disclosure police in transparency to allow patients to identify their own orientations that should be driven mainly by corporate social responsibility as a public service and not by the economic perspective of a business. This research confirms that as a global strategy for the health care system, corporate social responsibility is urgently needed. As a finite resource, the health should demand a permanent attention from society, as well as the Government in accomplishment prevention and monitoring systems, with a view to the defence of a sustainable health care system. More than merely investing efforts in fighting for political changes, without any advantage for society it is crucial to invest in prevention of the quality of life as a basic requirement to honour the corporate social responsibility in hospitals. Especially needed are health care improvements and infrastructures. In summary, the health care system exists as a fundamental element that assures life and high standards of living, so it should be available to everybody and for everybody…

Details

Social Responsibility Journal, vol. 1 no. 3/4
Type: Research Article
ISSN: 1747-1117

Article
Publication date: 5 September 2016

Katarina Kaarbøe and Anne Robbestad

This paper aims to explore how accrual accounting is translated into new accounting norms and what role change agents have had in that process. The main research question is: How…

Abstract

Purpose

This paper aims to explore how accrual accounting is translated into new accounting norms and what role change agents have had in that process. The main research question is: How were private sector accounting norms translated within the Norwegian public health sector?

Design/methodology/approach

This study uses framing theory to understand how the different actors involved in the translation frame their arguments. The field study considers the specific case of public health care. The main data sources are archival data combined with semi-structured interviews.

Findings

The empirical study uses framing theory to show how the Big Four consultants worked as change agents to impose a valuation based on a full accrual accounting logic. The first finding shows that there are two framing processes to valuate fixed assets. The central government has a pragmatic framing trying to get the budget in balance, while the Big Four consultants together with private sector accounting experts have an accrual accounting ideology framing. The second finding shows how the Big Four consultants become a change agent by forming alliances with accounting experts, health enterprises and politicians. These findings point to the need to focus explicitly on the role of change agents as drivers of public sector organizational change and the important role accounting as a tool can have.

Practical implications

The paper is likely to be useful for governments, practitioners and researchers to gain knowledge about the implementation of accrual accounting.

Originality/value

This paper contributes to our understanding of change agent's role in successfully introducing a new accounting logic in the public sector, especially within an inter-organizational setting.

Details

Journal of Accounting & Organizational Change, vol. 12 no. 3
Type: Research Article
ISSN: 1832-5912

Keywords

Article
Publication date: 21 April 2020

Chiara Oppi and Emidia Vagnoni

This paper aims to investigate the consequences of the coercive regulations for performance measurement and comparability that strengthened regional health authority’s control…

Abstract

Purpose

This paper aims to investigate the consequences of the coercive regulations for performance measurement and comparability that strengthened regional health authority’s control over organizations’ activities on management accountants’ relationship with clinician managers, who are the recipients of accounting information for decisional processes in health-care organizations. To achieve this aim, the research focuses on management accountants’ perception of their role and whether they perceive role conflict and role ambiguity.

Design/methodology/approach

A case study was undertaken in a public university hospital in the Emilia-Romagna region, Italy; 9 management accountants and 11 clinician managers were interviewed and secondary data analyzed.

Findings

Management accountants show low capabilities to support clinician managers’ decisional processes. Following the enactment of regulations, management accountants perform their role with a primary focus on functional responsibility. The focus on the provision of information to address regulations influenced management accountants’ capability to act as business partners in the organization. Because of the conflicting information needs from regulations and clinician managers, management accountants experience role conflict and ambiguity.

Research limitations/implications

The paper has implications for policymakers, underlining the consequences of strict regulations on management accountants’ role. It also emphasizes the importance of revising accounting techniques to satisfy both regional requirements and clinician managers’ needs for decision-making.

Originality/value

The article contributes to knowledge related to the role of management accountants in health care. It explores, in particular, the consequences of coercive regulations in health-care organizations, adding knowledge to a field that remains quite unexplored.

Details

Qualitative Research in Accounting & Management, vol. 17 no. 3
Type: Research Article
ISSN: 1176-6093

Keywords

Article
Publication date: 1 September 1994

Stewart Lawrence, Manzurul Alam and Tony Lowe

Examines the move towards a commercialized, economically driven, healthsector in New Zealand. Reforms involve extensive organizationalrearrangements and the creation of…

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Abstract

Examines the move towards a commercialized, economically driven, health sector in New Zealand. Reforms involve extensive organizational rearrangements and the creation of profit‐driven businesses in place of public hospitals. These institutional rearrangements involve the fabrication of new ways of accounting. Attempts to understand the processes involved in the development of information technologies before they become accepted “facts” of organizational life. The fabrication of new technologies cannot be understood as an autonomous sphere of activity, but has to be understood as part of a complex series of political, economic and organizational contexts. Accountants are viewed not as mere technicians reporting on what is, but as active agents contributing to change. Accounting often acts as an arbiter in social conflict. Nowhere is this more evident than in the way it is being called upon to assist in the implementation of clause 25 of the Health and Disability Services Bill, which requires hospitals in New Zealand to act as competitive profit motivated commercial enterprises while at the same time meeting unspecified social obligations. The creation of a pseudo‐market for health services presents a challenge not only for accountants, but for all New Zealand citizens. The outcomes of the radical reforms are uncertain and some fear that the massive restructuring is in the form of an experiment. It is based on an ideology lacking empirical support. In the end it may be shown to have been impractical in the New Zealand context.

Details

Accounting, Auditing & Accountability Journal, vol. 7 no. 3
Type: Research Article
ISSN: 0951-3574

Keywords

Open Access
Article
Publication date: 16 June 2023

Usman Abbas and Shehu Usman Hassan

This paper aims to examine the influence of procurement physiognomies on the creative accounting (CA) of listed health-care firms in Nigeria from 2016 to 2020.

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Abstract

Purpose

This paper aims to examine the influence of procurement physiognomies on the creative accounting (CA) of listed health-care firms in Nigeria from 2016 to 2020.

Design/methodology/approach

This paper used positivist paradigm. Annual reports and accounts, questionnaire and e-mails were used to obtained and extract quantitative data. The data were analyzed using OLS regression.

Findings

The study found that, procurement planning, e-procurement and procurement legislation compliance possessed negative weighty consequence on CA of quoted Nigerian health-care corporations while outsourcing, procurement staff competency and strategic supplier partnership possess positive substantial impact on the firms’ CA. The article concluded that procurement physiognomies play an important role in managing CA of health-care firms.

Research limitations/implications

This study findings are only applicable to listed health-care firms in Nigeria. It only used six procurement attributes. The research implication is that researchers are to use the findings in conducting further studies on procurement physiognomies and CA to help in coming up with ways of curbing irregularities in the organizations.

Practical implications

The health-care firms are to use the findings to come up with policies that ensure malpractices in procurement are curbed and CA is minimized to its barest level. Its societal implication is that the public is to use the findings in changing societal attitudes toward earnings manipulation.

Social implications

Its societal implication is that the public is to use the findings in changing societal attitudes toward earnings manipulation.

Originality/value

To the best of the authors’ knowledge, this article is the first to evaluate the influence of procurement physiognomies on CA in Nigerian-listed health-care companies. Many researchers neglect how procurement is used to carry out a lot of CA and this study focuses on a mechanism for curtailing corruption.

Book part
Publication date: 7 August 2019

Liisa Kurunmäki, Andrea Mennicken and Peter Miller

Much has been made of economizing. Yet, social scientists have paid little attention to the moment of economic failure, the moments that precede it, and the calculative…

Abstract

Much has been made of economizing. Yet, social scientists have paid little attention to the moment of economic failure, the moments that precede it, and the calculative infrastructures and related processes through which both failing and failure are made operable. This chapter examines the shift from the economizing of the market economy, which took place across much of the nineteenth century, to the economizing and marketizing of the social sphere, which is still ongoing. The authors consider a specific case of the economizing of failure, namely the repeated attempts over more than a decade to create a failure regime for National Health Service (NHS) hospitals. These attempts commenced with the Health and Social Care Act 2003, which drew explicitly on the Insolvency Act 1986. This promised a “failure regime” for NHS Foundation Trusts modeled on the corporate sector. Shortly after the financial crash, and in the middle of one of the biggest scandals to face NHS hospitals, these proposals were abandoned in favor of a regime based initially on the notion of “de-authorization.” The notion of de-authorization was then itself abandoned, in favor of the notion of “unsustainable provider,” most recently also called the Trust Special Administrators regime. The authors suggest that these repeated attempts to devise a failure regime for NHS hospitals have lessons that go beyond the domain of health care, and that they highlight important issues concerning the role that “exit” models and associated calculative infrastructures may play in the economizing and regulating of public services and the social sphere more broadly.

1 – 10 of over 62000