Towards a Contingency Theory for Hospital Cost Accounting Systems: A Comparison of the UK and New Zealand

  • Sheila Elwood


In the early 1990s both the UK and New Zealand embarked on an internal market approach to allocating healthcare financial resources. However, the approaches adopted in both costing and pricing healthcare have differed markedly. The study uses event analysis and case studies to identify differences between the two countries in the development of case-mix costing and the pricing/ funding mechanism. A number of forces at work at the macro level are similar. The UK has seen the introduction of a quasi market within the health service in the early 1990s followed by a shift to a more co-operative approach since 1997. However, the purchaser-provider split has been maintained. New Zealand has undergone similar changes in the healthcare sector. The responsibilities of the formerly vertically integrated Area Health Boards were redefined in terms of purchasers and providers of healthcare in the early 1990s but were modified after substantial health service deficits arose, and are currently implementing a reorganization with elected District Health Boards (DHBs).


National Health Service Accounting System Regional Health Authority National Health Service Trust District Health Authority 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Sheila Elwood

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