Hospital management accounting and control systems: a cross-sectional survey of Canadian hospitals

Abstract

This paper reports the results of a cross-sectional research study of management accounting and control systems in 82 hospitals across Canada. The research aimed to investigate the relationship of budgeting systems and a cost conscious climate to environment, CEO roles, performance, and tactical initiatives. The results indicate that hospital administrators are using these control systems as important management tools and that they are positively associated with hospital performance and for motivating actions designed to improve performance. The results also suggest that medical personnel - physicians and nurses - are gaining familiarity with hospital management accounting and control systems. Surprisingly, the environmental variable - crisis - was not associated with these systems. However, the study did not investigate, nor is cross-sectional methodology suitable for investigating the extent to which manipulation of accounting data and other kinds of goal incongruent behavior, as reported by researchers in other countries, takes place in Canada. Further research, including field studies, is needed to round out the picture in Canadian hospitals.