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

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Abstract

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).

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References

  • Blank, R.H. (1994), New Zealand Health Policy,Oxford University Press.

    Google Scholar 

  • Cooper, R. and Kaplan, R., (1991), The Design of Cost Management Systems, Englewood Cliffs, NJ, Prentice Hall.

    Google Scholar 

  • Covelski, M.A., Dirsmith, M.W. and Michaelman, J.E. (1993), An institutional perspective on the DRG framework, casemix accounting systems and healthcare organizations, Accounting Organizations and Society, p65–80.

    Google Scholar 

  • Department of Health, (1989a), Working for Patients,HMSO.

    Google Scholar 

  • Department of Health, (1989b), Self governing Hospitals, Working Paper 1, Working for Patients, HMSO.

    Google Scholar 

  • Department of Health, (1989c), Practice Budgets for Medical Practitioners, Working Paper 3, Working for Patients, HMSO.

    Google Scholar 

  • Department of Health, (1997), The New NHS- Modern, Dependable,The Stationery Office, Cm 3807. Department of Health, (1998a), A First Class Service,.

    Google Scholar 

  • Department of Health, (1998b), The new NHS: 1998 Reference Costs .

    Google Scholar 

  • Department of Health, (2000), The NHS Plan- A plan for investment, A plan for reform, The Stationery Office, Cm 4818–1.

    Google Scholar 

  • Ellwood, S.M. (1992), Cost Methods for NHS Healthcare Contracts,CIMA Research Foundation.

    Google Scholar 

  • Ellwood, S.M. (1996a), Full cost pricing in the NHS Internal Market: Accounting Choices and the Achievement of Productive Efficiency, Management Accounting Research, Spring 1996 Vol. 7 No 2.

    Google Scholar 

  • Ellwood, S.M. (1996b), Pricing services in the UK National Health Service, Financial Accountability and Management, Vol. 12 No 4 p281–301.

    Article  Google Scholar 

  • Ellwood, S.M., (2000), The NHS Financial Manager in 2010, Public Money and Management, Vol. 20 No 1 p23–30.

    Article  Google Scholar 

  • Emmanuel, C., Otley, D. and Merchant, K., (1990), Accounting for Management Control,Thomson Business Press.

    Google Scholar 

  • Enthoven, A.C., (1985), Reflections on the management of the National Health Service,Nuffield Provincial Hospitals Trust, Occasional Papers 5, London.

    Google Scholar 

  • Fetter, R.B. (1989), Introduction in DRGs and health care edited by Bardsley, Coles and Jenkins, King Edward’s Hospital Fund for London.

    Google Scholar 

  • Gibbs, A., Fraser, D. and Scott, J., (1988), Unshackling the Hospitals: Report of the Hospitals and Related Services Taskforce, Wellington, Government Print.

    Google Scholar 

  • Health Funding Authority (2000), Improving our Health —The Challenge for New Zealand, HFA, Wellington, New Zealand.

    Google Scholar 

  • Horngren, C.T., (1977), Cost Accounting: A managerial emphasis, Englewood Cliffs, NJ, Prentice Hall. Keen, J., (2000) Private health care: tough choices ahead, Health Care UK, Spring 2000 p27–29, King’s Fund, London.

    Google Scholar 

  • Kim, K.K., (1988), Organizational coordination and performance in hospital accounting information systems. An empirical investigation. The Accounting Review, 63 p472–489.

    Google Scholar 

  • Laughlin, R., Broadbent, J., Shearn, D. & Willing-Atherton, H. (1994), Recent financial and administrative changes in GP practices in the UK: Initial experiences and effects, Accounting Auditing and Accountability Journal p92–124.

    Google Scholar 

  • Lowe, A. and Doolin, B., (1999), Casemix accounting systems: new spaces for action, Management Accounting Research, Vol 10 p181–201.

    Article  Google Scholar 

  • Lowe, A. (2000), Accounting in Health Care: some evidence of the impact of casemix systems, British Accounting Review, 32 p189–211.

    Article  Google Scholar 

  • Liider, K., (1992), A Contingency Model of Governmental Accounting innovations in the Political-Administrative Environment, in Chan, J.L. and Patton, J.M. (eds.) Research in Governmental and Non profit Accounting, 7 p91–127.

    Google Scholar 

  • Mauldin, E.G., and Ruchala, L.V. (1999), Towards a meta-theory of accounting information systems, Accounting, Organizations and Society, 24 (4) p317–331.

    Article  Google Scholar 

  • Ministry of Health, (2000), Health Expenditure Trends in New Zealand 1980–1999, Wellington, New Zealand.

    Google Scholar 

  • NHSME (1990), Costing and Pricing Contracts:Cost Allocation Principles.

    Google Scholar 

  • Northcott, D. & Llewellyn, S. (2000), Making healthcare Costs visible: Evaluating the National Reference Costing Exercise, Paper presented at the MARG conference, Aston Business School.

    Google Scholar 

  • Packwood, T., Keen, J. and Buxton, M. (1991), Hospitals in Transition: the resource management experiment, Open University Press, Buckingham.

    Google Scholar 

  • Williamson, O.E., (1985), The economic institutions of capitalism, The Free Press, New York.

    Google Scholar 

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© 2002 Springer Science+Business Media New York

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Elwood, S. (2002). Towards a Contingency Theory for Hospital Cost Accounting Systems: A Comparison of the UK and New Zealand. In: Montesinos, V., Vela, J.M. (eds) Innovations in Governmental Accounting. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-5504-6_20

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  • DOI: https://doi.org/10.1007/978-1-4757-5504-6_20

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-5322-3

  • Online ISBN: 978-1-4757-5504-6

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