Contract-Based budgeting in health care: A study of the institutional processes of accounting change

Hyvönen, Timo; Järvinen, Janne

doi:10.1080/09638180500453189

Cited by 39 publications

(62 citation statements)

References 52 publications

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“…Accordingly, the change process seems to be path‐dependent, in that the existing institutions shaped the implementation process (Burns and Scapens, 2000). According to Hyvonen and Jarvinen (2006), it is possible to consider the introduction of the budget within Hospital A as a process where a compromise between the new rules and old, inherited institutionalized practices has been found.…”

Section: Resultsmentioning

confidence: 99%

NPM Reforms and the Perception of Budget by Hospital Clinicians: Lessons From Two Case‐studies

Macinati

2010

Financ Acc Manag

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This paper investigates how clinicians perceive managerial budgeting and how this affects clinical practice. To this end, case‐studies were conducted involving two Italian public hospitals. The results show that clinicians' commitment to organizational objectives was strongly enhanced by the use of the budget as a means to evaluate and reward clinicians' performance. One of the main lessons learned from this study is that aligning existing institutions to organizational objectives is the only way forward for effective reform implementation. Consequently, the challenge for future reforms is to deal with the search of balance between efficiency goals and existing institutions.

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Section: Resultsmentioning

confidence: 99%

NPM Reforms and the Perception of Budget by Hospital Clinicians: Lessons From Two Case‐studies

Macinati

2010

Financ Acc Manag

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“…Covaleski and Dirsmith, 1988;Abernethy and Chua, 1996;Brignall and Modell, 2000;Collier, 2001;Carmona and Grönlund, 2003). From an organisational viewpoint, NPM agendas involve privatisation, public-private partnerships, and where these are not possible, consumerism, quasi-markets, a purchaser -provider split and contract negotiations (Modell, 2003;Siverbo, 2004;Hyvönen and Järvinen, 2006).…”

Section: Organisational Context Of the Studymentioning

confidence: 99%

Institutional Logics, ICT and Stability of Management Accounting

Hyvönen

Järvinen

Pellinen

et al. 2009

European Accounting Review

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The purpose of this paper is to study the institutional logics of how and why two case units in the Finnish Defence Forces have reacted differently to external pressures originating from the State Audit Office to change their management accounting systems. The situation is made complex due to the fact that in military organisations, accountants' tasks have traditionally consisted of bookkeeping and financial reporting, while management accounting tasks especially (e.g. planning and control) have been performed predominantly by military personnel, who can be called hybrid accountants. The data for this study consists of project memos and interviews with people involved in designing and implementing enterprise-resource-planning (ERP)-linked cost accounting and reporting systems. In the case unit where management accounting and control had become institutionalised as a part of the uniformed officer's professional sphere, various resistance strategies (i.e. compromise strategy/pacifying tactics, avoidance strategy/buffering tactics and defiance strategy/dismissing tactics) were adopted. However, where this was not the case, the response was acquiescence. Despite the differences in responses to institutional pressure, the outcome for management accounting was the same. In the first case, demands for change were resisted, and in the second case, the old management accounting system was transferred into new information and communication technology (ICT) infrastructure without any significant change in content.

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“…One key idea in establishing comparable prices is the creation of the quasi-market; the idea that municipalities would be able to purchase health care products where the prices were lowest. Such ideas have been evinced in the creation of purchaser-provider models (Siverbo, 2004) managed care systems (Hyvönen and Järvinen, 2006).…”

Section: Management Accountants' Expressions Of Role and Identity: Prmentioning

confidence: 99%

Shifting NPM agendas and management accountants' occupational identities

Järvinen

2009

Accounting, Auditing &Amp; Accountability Journal

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Purpose -The purpose of this paper is to illustrate how the occupational identity of management accountants working in the public sector is influenced by a change in management accounting and control systems as well as the underlying management agenda. Design/methodology/approach -From interviews with management accountants and their associates in five public hospitals, the paper illustrates how a change in new public management (NPM)-related managerial agendas interacts with how the management accountants perceive their professional roles. Findings -It is argued that the focus of the NPM agenda in Finnish public health care has shifted from a "down grid agenda", emphasising private sector accounting and control methods, to a "down group agenda" that emphasises accountability, visibility and comparability. This change in agendas has materialised in the implementation of the diagnosis-related groups (DRG) system, and the resultant abandoning of activity-based costing (ABC) systems. Health care management accountants who rely on private sector ideals for constructing their occupational identity may resist the implementation of DRG if they interpret it as a shift in managerial discourse. Originality/value -The paper links two different and sometimes contradictory agendas within the NPM framework with the occupational identity of management accountants. The observed reaction to the shifting agendas has implications for understanding why some accounting systems carry more appeal than others.

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Contract-Based budgeting in health care: A study of the institutional processes of accounting change

Cited by 39 publications

References 52 publications

NPM Reforms and the Perception of Budget by Hospital Clinicians: Lessons From Two Case‐studies

NPM Reforms and the Perception of Budget by Hospital Clinicians: Lessons From Two Case‐studies

Institutional Logics, ICT and Stability of Management Accounting

Shifting NPM agendas and management accountants' occupational identities

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