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Evolution of the Governmental Accounting Reform implementation in Greek Public Hospitals: Testing the institutional framework

Listed author(s):
  • Stamatiadis, Filippos
  • Eriotis, Nikolaos
Registered author(s):

    Purpose – 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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    Paper provided by University Library of Munich, Germany in its series MPRA Paper with number 28816.

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    Date of creation: 31 Jan 2011
    Handle: RePEc:pra:mprapa:28816
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    1. 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.
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    3. 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 151-168.
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    5. Sven Modell, 2002. "Institutional perspectives on cost allocations: integration and extension," European Accounting Review, Taylor & Francis Journals, vol. 11(4), pages 653-679.
    6. 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.
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    8. Abernethy, Margaret A. & Vagnoni, Emidia, 2004. "Power, organization design and managerial behaviour," Accounting, Organizations and Society, Elsevier, vol. 29(3-4), pages 207-225.
    9. 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.
    10. Charalampos Economou & Claude Giorno, 2009. "Improving the Performance of the Public Health Care System in Greece," OECD Economics Department Working Papers 722, OECD Publishing.
    11. 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.
    12. 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.
    13. 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.
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    15. Isabelle Huault & V. Perret & S. Charreire-Petit, 2007. "Management," Post-Print halshs-00337676, HAL.
    16. Giroux, Gary, 1989. "Political interests and governmental accounting disclosure," Journal of Accounting and Public Policy, Elsevier, vol. 8(3), pages 199-217.
    17. FILIPPOS STAMATIADIS, Mr, 2009. "Investigating the Governmental Accounting Reform of Greek National Health System (ESY): Some preliminary Evidence," MPRA Paper 19649, University Library of Munich, Germany, revised 03 Sep 2009.
    18. 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.
    19. 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.
    20. Ron Hodges & Howard Mellett, 2003. "Reporting public sector financial results," Public Management Review, Taylor & Francis Journals, vol. 5(1), pages 99-113, March.
    21. 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.
    22. 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.
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