Accounting, microfoundations, hybridization and longitudinal conflict in a Finnish health care organization
PurposeThis article analyzes the cognitive microfoundations, conflicting institutional logics and professional hybridization in a case characterized by conflict.Design/methodology/approachIn contrast to the majority of earlier studies focusing on special health care, the study was conducted in a Finnish basic health care organization. The empirical data include 36 interviews, accounting reports, budgets, newspaper articles and meeting notes collected 2013–2018.FindingsThe use of accounting techniques in this case did not offer professionals sufficient support under conditions of conflict. The authors suggest that this perceived lack of support intensified the negative emotions toward accoun…
Blame game or dialogue? Financial, professional and democratic accountabilities in a complex health care setting
Purpose The purpose of this paper is to investigate how the complexity of the network governance setting affects accountability practices. The authors pay particular attention to the organizational characteristics that may enable a common understanding of multiple accountability relationships, or lead to problems in reconciling competing forms of accountability, thereby appearing as blame game-type behavior. Design/methodology/approach The authors conducted a case study with 31 semi-structured interviews in a Finnish health care organization (FHC) that offers basic public health care services. The organization represents a co-operative arrangement with the main city and three smaller munic…
Quality management in the public sector accounting department - (un)avoidable quality costs and unlikely financial impacts
This paper investigates the nature of quality costs and the likelihood of their having financial impacts in the public sector. An illustrative quality development case project in an accounting department of a Finnish city administration is presented. The empirical data includes answers to a qualitative project question sheet, workshop material and participative observation. Quality problems are classified according to their quality cost category and the extent to which they are avoidable. Some of the quality costs proved unavoidable and some are likely to lack financial impact, exhibiting sticky cost behaviour. The study indicates that certain prevention and appraisal costs in the public se…
Cost Management in the Public Sector: Legitimation Behaviour and Relevant Decision Making
This paper presents a case study where a cost management project was implemented using action research methodology at two Finnish organizations working in a purchaser–provider relationship. While the study demonstrates the efficiency-seeking motive behind the implementation of the management accounting tool, subsequent investigation found that tool remained partly unused despite showing its potential relevance for practice through user involvement. However, this does not necessarily signal legitimation-seeking behaviour. Reasons for not using some parts of the tool point to an overestimation of the functionality and an underestimation of implementation problems during the design process. Th…
Cost Management in the Public Sector : Legitimation Behaviour and Relevant Decision Making
This paper presents a case study where a cost management project was implemented using action research methodology at two Finnish organizations working in a purchaser–provider relationship. While the study demonstrates the efficiency-seeking motive behind the implementation of the management accounting tool, subsequent investigation found that tool remained partly unused despite showing its potential relevance for practice through user involvement. However, this does not necessarily signal legitimation-seeking behaviour. Reasons for not using some parts of the tool point to an overestimation of the functionality and an underestimation of implementation problems during the design process. Th…
Kontrollikuutio : riskipainotettu kustannusvaikuttavuuden analyysi- ja johtamismalli kunnallisessa perusterveydenhuollossa
There have been calls for cost-effective public services and the integration of management control and risk management systems. Municipalities currently need to consider aging populations and diminishing financial resources. But municipal services may also include other risks, such as reputational and political risks, along with changes in legislation as well as unexpected changes in operating circumstances. Risks and how they are managed affect both the costs and the effectiveness of municipal services. However, cost-effectiveness and risks are not clear-cut concepts, especially in the public health services. Therefore, in order to better understand risks in public sector management contro…
Perspectives on Relevance : the Relevance Test in the Constructive Research Approach
Abstract Interventionist research (IVR), such as the constructive research approach (CRA), has been suggested as a method to improve the relevance of management accounting (MA) research. Although literature identifies several perspectives on relevance, the current assessment of CRA focuses on practical relevance. Moreover, an overreliance on pragmatism in assessing CRA research in the form of CRA market tests has been criticized. This article analyses the challenges inherent in conducting and assessing CRA research, both conceptually and with a CRA case example. In order to overcome these possible CRA challenges, we suggest analyzing CRA relevance from multiple perspectives. The perspective…