Evolution of the Governmental Accounting Reform implementation in Greek Public Hospitals: Testing the institutional framework
AbstractPurpose – In an attempt to promote efficiency, effectiveness and economy in health service production, the Greek government imposed in 2003 an accrual basis financial and cost accounting system in all public hospitals of the National Health System (NHS). The purpose of this study is not to investigate thoroughly the accounting reform implementation and adoption in specific organizations, but rather to obtain an overall idea of the reform adoption process in Greek public hospitals by identifying major areas of non-compliance with the mandatory legislative accounting framework and various organisational contingencies that influence the level of reform adoption within a broad institutional framework. Design/methodology/approach – Our analysis is based on the results of an empirical survey that took place during 2009. For the purposes of this survey, a compliance index is constructed and applied on a sample of 94 Greek public hospitals using a structured questionnaire and semi-structured interviews with six public hospital Financial and Accounting executives. Findings – The empirical evidence reveals that the level of accrual basis financial and especially cost accounting adoption in Greek public hospitals is realized only to a limited extent. In particular, results show that the relationship between the institutional isomorphic pressures and accounting reform implementation process is restricted by organizational capability factors (i.e., the quality of existing Information Technology systems, the education level of finance and accounting staff, the extent of reform related training, and the professional support of consultants). Research limitations/implications – Although this study takes into consideration the work of previous researchers in the health care area, it acknowledges that empirical research on the subject in the Greek environment is limited. Therefore this study should be viewed as an initial step to address this limitation. Originality/value – This study draws on the information systems change, management accounting innovation, and public sector reform literatures to contribute to the current knowledge in public sector accounting by examining a number of factors that are expected to influence the implementation and adoption process of accrual and cost accounting practises in the Greek public healthcare sector within a broad institutional framework. Contribution - This study contributes to the international literature of New Public Management (NPM) initiatives in public health sector by providing, to our knowledge, the first large cross-sectional assessment of accrual accounting reform adoption and implementation in Greek public hospitals. Additionally, the empirical evidence of this study can enhance researchers’ and managers’ understanding of major implementation processes and challenges and thus help them refine models of effective implementation process and improve systems and processes on similar future projects.
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Bibliographic InfoPaper provided by University Library of Munich, Germany in its series MPRA Paper with number 28816.
Date of creation: 31 Jan 2011
Date of revision:
Accrual Accounting; Public Sector Accounting; Compliance Index; Public Hospitals; Isomorphism.;
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- M41 - Business Administration and Business Economics; Marketing; Accounting - - Accounting - - - Accounting
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- Abernethy, Margaret A. & Vagnoni, Emidia, 2004. "Power, organization design and managerial behaviour," Accounting, Organizations and Society, Elsevier, vol. 29(3-4), pages 207-225.
- Cavalluzzo, Ken S. & Ittner, Christopher D., 2004. "Implementing performance measurement innovations: evidence from government," Accounting, Organizations and Society, Elsevier, vol. 29(3-4), pages 243-267.
- Eddy Cardinaels & Filip Roodhooft & Gustaaf Van Herck, 2004.
"Drivers of cost system development in hospitals: results of a survey,"
Vlerick Leuven Gent Management School Working Paper Series
2004-09, Vlerick Leuven Gent Management School.
- Cardinaels, Eddy & Roodhooft, Filip & Herck, Gustaaf van, 2004. "Drivers of cost system development in hospitals: results of a survey," Health Policy, Elsevier, vol. 69(2), pages 239-252, August.
- James L. Chan, 2003. "Government Accounting: An Assessment of Theory, Purposes and Standards," Public Money & Management, Chartered Institute of Public Finance and Accountancy, vol. 23(1), pages 13-20, 01.
- Noel Hepworth, 2003. "Preconditions for Successful Implementation of Accrual Accounting in Central Government," Public Money & Management, Chartered Institute of Public Finance and Accountancy, vol. 23(1), pages 37-44, 01.
- Sven Modell, 2002. "Institutional perspectives on cost allocations: integration and extension," European Accounting Review, Taylor & Francis Journals, vol. 11(4), pages 653-679.
- Geiger, Dale R. & Ittner, Christopher D., 1996. "The influence of funding source and legislative requirements on government cost accounting practices," Accounting, Organizations and Society, Elsevier, vol. 21(6), pages 549-567, August.
- Charalampos Economou & Claude Giorno, 2009. "Improving the Performance of the Public Health Care System in Greece," OECD Economics Department Working Papers 722, OECD Publishing.
- Inger Johanne Pettersen, 2001. "Implementing management accounting reforms in the public sector: the difficult journey from intentions to effects," European Accounting Review, Taylor & Francis Journals, vol. 10(3), pages 561-581.
- Coombs, R. W., 1987. "Accounting for the control of doctors: Management information systems in hospitals," Accounting, Organizations and Society, Elsevier, vol. 12(4), pages 389-404, June.
- Elias Mossialos & Sara Allin & Konstantina Davaki, 2005. "Analysing the Greek health system: a tale of fragmentation and inertia," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S151-S168.
- James E. Bailey & Sammy W. Pearson, 1983. "Development of a Tool for Measuring and Analyzing Computer User Satisfaction," Management Science, INFORMS, vol. 29(5), pages 530-545, May.
- Giroux, Gary, 1989. "Political interests and governmental accounting disclosure," Journal of Accounting and Public Policy, Elsevier, vol. 8(3), pages 199-217.
- Odysseas Pavlatos & Ioannis Paggios, 2009. "Management accounting practices in the Greek hospitality industry," Managerial Auditing Journal, Emerald Group Publishing, vol. 24(1), pages 81-98, January.
- Jegers, Marc & Kesteloot, Katrien & De Graeve, Diana & Gilles, Willem, 2002. "A typology for provider payment systems in health care," Health Policy, Elsevier, vol. 60(3), pages 255-273, June.
- Cheng, Rita Hartung, 1992. "An empirical analysis of theories on factors influencing state government accounting disclosure," Journal of Accounting and Public Policy, Elsevier, vol. 11(1), pages 1-42.
- Evans, John III & Patton, James M., 1983. "An economic analysis of participation in the municipal finance officers association certificate of conformance program," Journal of Accounting and Economics, Elsevier, vol. 5(1), pages 151-175, April.
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