BackgroundAccurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre.MethodsTwo thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC) model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions.ResultsThe correlation coefficient amounted to 0.73 (95%CI: 0.72; 0.76). The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Beta = −2.4; p = 0.02), ASA score (Beta = 76.3; p<0.001), RCI (Beta = 5.5; p<0.001), staffing level (Beta = 437.0; p<0.001) and intervention duration (Beta = −10.5; p<0.001).ConclusionsThe ability of the current method to provide relevant information to managers, clinicians and payers is questionable. As in other European countries, a shift towards time-driven activity-based costing should be advocated.

Résumé En se basant sur le courant « Reliance on Accounting Performance Measures » (RAPM) cet article a pour objectif de proposer une réflexion sur les effets du contrôle des résultats introduit à l’hôpital public. Ce travail exploratoire, réalisé à partir de 31 entretiens semi-directifs, tente de comprendre la problématique du RAPM ainsi que ses effets sur les attitudes et les comportements des professionnels du secteur hospitalier public. Les résultats révèlent l’existence d’une pression budgétaire qui s’accompagne de conflits de rôle, des résistances et une tendance à la manipulation de données. En soulignant le caractère réducteur des précédents travaux menés dans le champ du RAPM, l’étude propose d’intégrer dans la compréhension du phénomène, les dimensions organisationnelles et institutionnelles de l’hôpital.

PurposeThe aim of this paper is to confront the Balanced Scorecard (BSC) with Simons’ levers of control model and to discuss its role in the various phases of the strategic process. The authors examine the role of the BSC as a tool of interactive and diagnostic control by making a distinction between its design phase and its phase of use.Design/methodology/approachAn action research approach, based on two cases, was used to investigate the role of the balanced scorecard in strategic processes.FindingsThe results show that the BSC generates a process of collective elucidation favouring the forming of emergent strategies and a process of control of the change favouring the collective representations on the strategy. The BSC thus seems to be a relevant tool for interactive control during its implementation stage. On the other hand, the authors’ observations also show the failure of the BSC as a system of diagnostic control and of interactive control during its using stage. Ultimately, it is shown that the model of Simons provides the BSC with a relevant theoretical framework to clarify the practice of strategic control.Research limitations/implicationsThe study highlights the interest of field studies, and more particularly, processuals and longitudinal approaches, in management accounting research.Practical implicationsThe study of two cases underlines the strategic contribution of the BSC by highlighting its role in building a strategy.Originality/valueThe field study allows us to observe how the design of a management control tool such as the BSC occurs during the strategy‐forming phase.

Purpose Kaplan and Norton proposed the strategy map as a way to overcome the weaknesses of the balanced scorecard (BSC), but this approach may not be enough. The purpose of this paper is to present a strategic management control package composed of three systems from strategic management and management control. This conceptual approach operationalizes strategic alignment, which is the core interest of the BSC. Design/methodology/approach The rationale for this research is derived from the literatures on business models (BMs), the BSC and management control packages. The authors first identified gaps in the BSC literature, which has underlined the BSC’s insufficient connection to strategy, and the strategic literature, which has criticized the BM as being too conceptual. The authors propose to fill these gaps through contributions from the management control package literature. Findings The findings are in line with the current literature on the interdependencies of management control systems. In response to the criticism of the BSC because of its weak strategic foundations, the authors provide a framework comprising three management systems: the BM, the strategy map and the BSC. This framework ultimately promotes two feedback loops that provide a dynamic view of the reciprocal influences of the BSC and strategy. Research limitations/implications Several authors note that the BSC suffers from a lack of conceptualization. The underlying assumptions and the conceptual and empirical validity of the cause-and-effect relationships are particularly questioned. Therefore, the purpose of this paper is to overcome the criticism linked to the “low” strategic alignment of the strategy map, and then of the BSC, by proposing a conceptual framework based on a package including three management systems: the BSC, the strategy map and the BM. A major limit lies in the purely conceptual dimension of this research, and it will be interesting to empirically investigate the conceptual package through longitudinal case studies. Practical implications The authors propose guidelines to develop a strategically aligned BSC through a three-step operationalization process to achieve a non-linear strategic management control. Moreover, the authors suggest empirical research avenues to address the weaknesses of Kaplan and Norton’s BSC and to enhance its connection to strategy through an integrated strategic management control package that includes a BM. Originality/value This paper adds value by proposing a package of management systems that includes both strategic management and management control perspectives. The authors, therefore, offer a way to bridge the gap between these research streams and highlight the interest of recent developments in the literature regarding the management control package.

No abstract

La supply chain fournit un exemple d'entreprise virtuelle dans laquelle plusieurs organisations sont aujourd'hui étroitement impliquées dans un même réseau de relations formant une entité plus vaste qui les transcende en un tout organisé. La qualité des collaborations qui s'instaurent au sein de cette entité virtuelle apparaît comme un facteur critique de son efficacité. Si dans la littérature, comme dans le sens commun, la thèse d'un antagonisme entre confiance et contrôle est souvent avancée, les pratiques actuelles développées dans la gestion de la supply chain tendent à montrer que ces expériences de collaboration conjuguent intimement confiance et contrôle.

Cet article porte sur les questionnements identitaires de l’enseignant-chercheur en sciences comptables. Enseignant et chercheur à la fois, ce dernier en quête d’identité est confronté à plusieurs dilemmes de nature épistémologique et didactique, le conduisant à un « va et vient » entre recherche et pédagogie. Envisagé comme un relais des pratiques comptables, l’enseignant-chercheur en comptabilité, contrôle, audit, peut s’identifier comme un traducteur mimétique et un agent légitimateur de ces pratiques. En même temps, il apparaît également comme un constructeur de théories comptables. En quête de lectures théoriques, c’est dans les fondamentaux économiques et organisationnels, que le chercheur peut construire les bases de son enseignement.

International audienc