SYNOPSIS
The rising cost of healthcare is a globally pressing concern. This makes detailed attention to the way in which costing is carried out of central importance. This article offers a framework for considering the interdependencies between a dominant element of the contemporary healthcare context, i.e., Diagnosis Related Group (DRG) systems, and costing practices. DRG-based payment systems strongly influence costing practices in multiple ways. In particular, setting DRG tariffs requires highly standardized costing practices linked with specific skill sets from management accountants and brings other jurisdictions (e.g., clinical coding) to bear on costing practice. These factors contribute to the fragmentation of the jurisdiction of management accounting.
In this paper, we examine neglected dimensions of decoupling - i.e., its power and political aspects. We draw on an empirical study of the reaction of two hospital subunits and an external agency (the Regional Health Agency) to a policy implementation, to contribute to the recent renewed interest in decoupling. We first reconsider the distinction between internal and external actors by investigating how they interact in their responses to the new policy implementation. While observing different forms of decoupling, we show how power and politics allow us to understand how these forms are articulated and related. Furthermore, we highlight that contexts characterized by institutional complexity are particularly propitious for decoupling. Finally, we outline that how actors use logics to justify their claims might differ significantly from how they enact those logics. More broadly, this paper contributes by bringing back power and politics into the analysis of institutional processes.
With globalization in business academia expanding and deepening, it is timely to question the validity and utility of the concept of country of origin as a base category for comparative cross-cultural research and theory development. In their contribution in the British Journal of Management, Burgess and Shaw (2010) rank the most productive institutions and countries contributing to board membership of top ranked journals on the basis of their country of origin. Taking their findings as a starting point for our discourse, we re-analyse their database, in addition to our own investigations. We contend that while country of origin may be an appropriate category for betweencountries comparison of multinational entities, it is of little use when comparing metanational institutions, such as top tier refereed journal boards and the globalized business/ management schools from which they are drawn. Our findings point towards the need for finer differentiation of what constitutes the concept country of origin, but also that its relevance should be questioned in, at least, globalized contexts. The question we pose extends to any pertinent 'globalized' topic within and without business and management.
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