Tight budgetary control: A study of clinical department managers’ perceptions in Swedish hospitals

Abstract

Perception of tight budgetary control by managers depends on both their personal characteristics and the financial situation of their departments. Differences between men and women, and doctors and non-doctors call for additional research about the possible impact of changes in the composition of clinical department managers on how budgetary responsibility is exercised.

Perception of budgetary control: a study of differences across managers in Swedish public primary healthcare related to professional background and sex

“…The results in this study indicate that nurses and other non‐physicians with managerial responsibilities may be more committed to budgets than the average physician. These results correspond with previous research related to professionals’ different views about budgetary control in health‐care service (Abernethy & Stoelwinder 1988, Nylinder 2009). The difficulties of getting physicians in publicly owned hospitals to take responsibility for the overall use of resources have considerable support in research (Coombs 1987, Comerford & Abernethy 1999, Lapsley 2001).…”

“…No significant association was found between the managers’ perception of tight budgetary control and how close the mangers were to their own budget targets. This type of association has been reported across hospital managers in Swedish health care (Nylinder 2009).…”

“…Managers in organizations or units with deficits have a tendency to attract more attention than managers in organizations or units with balanced budgets (Merchant & Van der Stede 2003). In hospitals, managers with balanced department budgets perceived the budgetary control to be tighter than did managers whose department budget were highly overspent (Nylinder 2009). The financial situation was measured by the percentage of budget achievement during the first 6 months of 2008.…”

“…However, the increase of professionalization of nurses seems to have influenced their bureaucratic behaviour in the sense that their conflicts with the bureaucratic system have worsened (Fourcher & Howard 1981). Furthermore, previous research has shown that health‐care managers with different professional backgrounds have different views of the management control system, including the process of budgeting (Abernethy & Stoelwinder 1988, Nylinder 2009). The changed composition of managers in Swedish public primary care provides access to perform studies that directly focus on differences based on professional background.…”

Better with GPs as managers? – Variation in perceptions of feedback messages, goal-clarity and performance across manager´s in Swedish primary care

“…Indeed, a recent study based on interviews noted a difference in leadership style between GP and non-GP managers in Swedish primary care [ 9 ]. Previous studies indicate that nurse PCP managers are more committed to budgetary control and objectives assigned by regions in comparison with physician managers [ 10 , 14 ]. However, to our knowledge, there is no empirical research investigating the possible association between managers’ professional background and PCP performance.…”