Capped hospital budgets, risk-influencing activities and financial consequences

Ernst, Christian; Szczesny, Andrea

doi:10.1016/j.jaccpubpol.2007.11.002

Cited by 18 publications

(11 citation statements)

References 36 publications

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“…The topic gained relevance after 1995, and although there was a slight decrease between 2000 and 2005, a total of 18 papers were published between 2006 and 2016. The articles in this field referred in particular to changes in AISs to link costs and resource consumption, such as the implementation of new accounting techniques (e.g., activity-based systems) within HCOs, the integration of AISs with clinical data, or the provision of nonfinancial information which can fit clinicians' information needs and increase their willingness to adopt a managerial approach (e.g., Campanale, Cinquini, & Tenucci, 2014;Demeere, Stouthuysen, & Roodhooft, 2009;Eldenburg et al, 2010;Ernst & Szczesny, 2008;Hellman, Kastberg, & Siverbo, 2015;Kaplan & Witkowski, 2014).…”

Section: Temporal Viewmentioning

confidence: 99%

Clinicians and accounting: A systematic review and research directions

et al. 2019

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This paper provides a review of the literature concerning clinicians’ approach to accounting information systems (AISs) in healthcare organizations. The paper examines highly rated accounting and management literature since 1980. Articles are categorized according to their research topics, settings, and methodologies, then findings are analyzed. Results show that clinicians’ resistance to accounting is the consequence of the inadequacy of AISs, which are designed according to reforms inspired by a managerial orientation. This suggests that future research should focus on AISs design, investigating patterns of implementation of AISs that can increase clinicians’ commitment to and use of accounting for decision making.

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Section: Temporal Viewmentioning

confidence: 99%

Clinicians and accounting: A systematic review and research directions

et al. 2019

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“…For a review of the health‐care system in Germany, see Busse and Riesberg (), Ernst and Szczesny (), Leidl (), and Kamke ().…”

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confidence: 99%

“…In addition, the reimbursement mechanism provided incentives to cherry‐pick low‐risk patients (Ernst and Szczesny ).…”

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confidence: 99%

“…For a review of the health-care system in Germany, see Busse and Riesberg (2004), Ernst and Szczesny (2008), Leidl (1995), and Kamke (1998). was rather used to justify historical costs or to make a case for future expected costs during the course of budget negotiations (Soderstrom, Eldenburg, and Ernst 2006). As a result, inefficiencies hidden in hospital-specific per diem rates were carried forward into subsequent periods.…”

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confidence: 99%

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The Impact of Changes in Regulation on Cost Behavior

Holzhacker

Krishnan

Mahlendorf

2014

Contemporary Accting Res

117

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“…More recently, Eastaugh interpreted a new wave of specialization as a response to managed care decreasing patient volumes and to payors offering tighter hospital reimbursements. Outside the United States, Ernst and Szczesny reported a significant specialization reaction to the capped budget reforms of 1993 and 1996 in Germany.…”

Section: Literature Reviewmentioning

confidence: 99%

Does DRG funding encourage hospital specialization? Evidence from the Italian National Health Service

Pessina

Nieddu

Rizzo

2018

Health Planning & Management

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Summary The impact of diagnosis‐related group (DRG)‐based funding has been analyzed along a wide range of dimensions. Its effects on hospital specialization, however, have been investigated only sparsely. This paper examines such effects in the context of the Italian National Health Service, where decentralization has produced a significant degree of variation in funding arrangements. To this end, a 9‐year panel data set covering 762 Italian public and private hospitals was analyzed using a finite mixture model approach. Hospital specialization was measured by the internal Herfindahl‐Hirschman Index. Three variables were introduced as proxies for the choices made by Italian Regions with respect to the development and use of their DRG systems. The best finite mixture model identified three groups of hospitals, two of which sizeable. Of these, one included nearly all public hospitals, while the other was composed almost exclusively of small and medium‐sized investor‐owned hospitals. Averagely, private and smaller hospitals showed a stronger tendency to specialize over time. The positive impact of DRG funding on the hospitals' propensity to specialize found only limited empirical support. Moreover, it emerged as comparatively much smaller for public hospitals vis à vis private ones.

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Capped hospital budgets, risk-influencing activities and financial consequences

Cited by 18 publications

References 36 publications

Clinicians and accounting: A systematic review and research directions

Clinicians and accounting: A systematic review and research directions

The Impact of Changes in Regulation on Cost Behavior

Does DRG funding encourage hospital specialization? Evidence from the Italian National Health Service

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