The Role of Performance Reporting System Characteristics for the Coordination of High-Cost Areas in Hospitals

Szczesny, Andrea; Ernst, Christian

doi:10.1080/09638180.2016.1210525

Cited by 7 publications

(9 citation statements)

References 66 publications

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“…Clinicians require AISs linking accounting information with the care activity performed Cherry et al, 2011;Conrad and Guven Uslu, 2011;Hoyt & Lay, 1995;Lewis et al, 1996;Lowe & Doolin, 1999;Lowe, 1997;Scarparo, 2006;Szczesny & Ernst, 2016;Vera & Kuntz, 2007 Some HCOs have attempted to implement process-based AISs, showing the advantages of AISs that fit both clinicians and controllers' needs Ballantine et al, 1998;Campanale et al, 2014;Chan, 1993;Demeere et al, 2009;Devine et al, 2000;Driver, 2001;Ernst & Szczesny, 2008;Goldschmidt & Gafni, 1990;Hellman et al, 2015;Hoyt & Lay, 1995;Kaplan & Porter, 2011;Kaplan & Witkowski, 2014;Paulus et al, 2002;Pizzini, 2006;…”

Section: Articlesmentioning

confidence: 99%

“…Because of the inadequacy of AISs for decision making and following their new responsibility for efficiency and quality improvement, the literature presents evidence of clinicians' increasing requirement of AISs to provide both quality and activity data, and to develop their capability to link top-down processes and the managerial control assigned by regulations with the care activities performed (Cherry et al, 2011;Conrad and Guven Uslu, 2011;Lewis et al, 1996;Lowe, 1997;Lowe & Doolin, 1999;Purdy, 1993;Scarparo, 2006;Szczesny & Ernst, 2016).…”

Section: Characteristics Of Aissmentioning

confidence: 99%

“…In this regard, activity-based costing and management are examples of processbased techniques, which provide advantages in comparison to conventional AISs, such as supporting decision making and helping controllers in cost reduction by focusing on nonvalue-added activities (Chan, 1993;Devine et al, 2000;Driver, 2001;Kaplan & Porter, 2011;Kaplan & Witkowski, 2014). Furthermore, process-based tools have the capability to provide information for decision making at unit and organizational levels, thus fitting both clinicians' and controllers' needs (Paulus et al, 2002;Pizzini, 2006;Szczesny & Ernst, 2016;Voss, Limpens, Brans-Brabant, & van Ooij, 1997). This would allow clinicians to overcome cost-containment policies and to address cost-saving actions, gaining the autonomy they had lost when managerial reforms were implemented (Wickramasinghe, 2015).…”

Section: Characteristics Of Aissmentioning

confidence: 99%

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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: Articlesmentioning

confidence: 99%

Section: Characteristics Of Aissmentioning

confidence: 99%

Section: Characteristics Of Aissmentioning

confidence: 99%

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Clinicians and accounting: A systematic review and research directions

et al. 2019

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“…Although there is still limited evidence in this regard, we sustain that more developed CS produce ''better" (i.e., more relevant and useful) data that enhance managerial decisionmaking, and thereby lead to improved efficiency (Pizzini, 2006;Szczesny & Ernst, 2016). Also it should be noted that we study a period which subjected Spanish NHS hospitals to the most stringent budgetary constraints derived from the economic crisis.…”

Section: Measure Of the Level Of Development Of The Cost Systemmentioning

confidence: 55%

Influence of cost systems on efficiency. An analysis of Spanish hospitals using public national databases

García-Cornejo

Méndez

2020

RC-SAR

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Este trabajo analiza si el nivel de desarrollo de los sistemas de costes hospitalarios (SC) implementados por los Servicios Regionales de Salud (SRS) españoles tiene algún efecto en la eficiencia de los hospitales. Para ello, utilizamos los datos públicos de 159 hospitales del Sistema Nacional de Salud (SNS) español entre 2010 y 2013, el período de mayores restricciones presupuestarias derivadas de la crisis económica. Aplicamos tres metodologías: primero, un modelo de análisis envolvente de datos (AED) convencional seguido de una regresión Tobit; segundo, un procedimiento de dos pasos con doble bootstrap propuesto por Simar y Wilson (2007), y tercero, el cálculo del índice Malmquist y la aplicación de regresión logística para explicar el cambio en la eficiencia. Encontramos que en el contexto estudiado hay una relación directa entre un SC más desarrollado y la mejora de la eficiencia. Nuestros resultados sugieren que los responsables políticos y los reguladores deberían incentivar el desarrollo de SC hospitalarios estandarizados. This paper analyzes whether the level of development of the hospital cost systems (CS) implemented by the Spanish Regional Health Services (RHS) has an effect on hospital efficiency. For this purpose, we used the public data of 159 hospitals of the Spanish National Health System (NHS) between 2010 and 2013, the period of the most stringent budgetary constraints derived from the economic crisis. We apply three methodologies: first, a conventional data envelopment analysis (DEA) model followed by a Tobit regression; second, a two-step procedure with a double bootstrap proposed by Simar & Wilson (2007), and third, the calculation of the Malmquist index and the application of logistic regression to explain the change in efficiency. We find that in the context studied there is a direct relationship between the most developed CS and the improvement of efficiency. Our findings suggest that policy makers and regulators should incentivize the development of standardized hospital CS.

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“…Managerial reforms have strongly emphasized the need for standardization and comparability of financial and managerial results, and the need for benchmarking comparisons among organizations (Lehtonen, 2007;Guven Uslu and Conrad, 2008). In addition, organizational changes, innovative treatments and the competitive environment required information that was more accurate and centered on processes which drove demand for accounting information that is able to link economic perspectives with the emerging needs of clinician managers for decision-making at a unit level (Conrad and Guven Uslu, 2011;Szczesny and Ernst, 2016). This can challenge the role of MAs by stressing the need to provide reliable accounting information while raising the possibility of a revision of their activities toward an increasing involvement in business management.…”

Section: Literature Reviewmentioning

confidence: 99%

Management accountants’ role and coercive regulations: evidence from the Italian health-care sector

Oppi

Vagnoni

2020

QRAM

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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.

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The Role of Performance Reporting System Characteristics for the Coordination of High-Cost Areas in Hospitals

Cited by 7 publications

References 66 publications

Clinicians and accounting: A systematic review and research directions

Clinicians and accounting: A systematic review and research directions

Influence of cost systems on efficiency. An analysis of Spanish hospitals using public national databases

Management accountants’ role and coercive regulations: evidence from the Italian health-care sector

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