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Kantola, H. (Hannele). "Management accounting change in public health care." Doctoral thesis, Oulun yliopisto, 2014. http://urn.fi/urn:isbn:9789526204680.
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Abstract The aim of this dissertation is to analyse the process of change in management accounting in public-sector health care. The change is examined through the implementation of a nationally homogeneous Diagnosis Related Grouping (DRG) system. The DRG system is used to classify health-care diagnoses into groups for service productisation and pricing. The system has been proposed as a solution for cost accounting and budgeting. The practical motivation of the dissertation is to analyse the embedding of change in organisations´ practises. The theoretical motivation of the dissertation is to extend the investigation of change by analysing the process of implementation of a nationally homogeneous system. The research data comprise 39 interviews conducted between 2006 and 2011 with hospital district representatives, the representatives of the company managing the DRG system, the DRG system supplier, and the representatives of the National Institute for Health and Welfare and the Association of Finnish Local and Regional Authorities. In addition to interviews, the data consists of participative observations, telephone inquiries, and newspaper articles. This dissertation consists of four essays that analyse the data through the lens of two theories: the Actor Network (ANT) and Institutional theory (NIS). The results indicate how the use of multiple theories (ANT ja NIS) as a methodology enriches and extends the insight into the change process in management accounting. For instance, the analysis of the homogeneous use of the DRG system, without investigating the practices of actors by making use of the ANT, the results could have been different in this respect. Especially, this dissertation indicates how important it is that actors’ actions are also examined in the processes of change in the implementation of public-sector management accounting systems. The idea for the DRG system was introduced to Finland almost twenty years ago. However, the results indicate that it has spread very slowly. According to earlier research, an institutional environment is considered to exercise pressure on organisations in order to make them adopt new practices that are homogeneous with other institutional practices. There is indirect pressure in decentralised health care in Finland, though its power for change is weak. This dissertation shows how the decentralisation of responsibilities in large-scale institutions, such as the health-care system in Finland, also slows down and decentralises reforms. As institutional power becomes weaker, the power of organisations to promote things seems to grow stronger, howeverTiivistelmä Tämän väitöskirjatyön tarkoituksena on analysoida johdon laskentatoimen muutosprosessia julkisen sektorin terveydenhoidossa. Muutosta tarkastellaan kansallisesti yhtenäisen diagnoosiperustaisen ryhmittelyjärjestelmän (Diagnosis Related Grouping, DRG) käyttöönottoprosessin kautta. DRG on järjestelmä, jossa luokitellaan terveydenhoidon diagnoosit ryhmiin palvelujen tuotteistusta ja hinnoittelua varten. Järjestelmää on esitetty ratkaisuna kustannuslaskentaan ja budjetointiin. Väitöskirjatyön käytännön motivaationa on analysoida muutoksen asettumista organisaatioiden käytäntöihin. Väitöskirjatyön teoreettisena motivaationa on laajentaa muutostutkimusta tarkastelemalla kansallisesti yhtenäisen järjestelmän käyttöönottoa. Tutkimuksen aineisto koostuu 39 haastattelusta, joita on kerätty vuosien 2006 ja 2011 välillä. Tutkimuksessa on haastateltu sairaanhoitopiirien henkilökuntaa, DRG-järjestelmän hallinnoiman yhtiön edustajia, järjestelmän toimittajaa, Terveyden ja hyvinvoinnin laitoksen sekä Kuntaliiton edustajia. Aineisto sisältää haastattelujen lisäksi osallistuvaa havainnointia, puhelinkyselyjä sekä lehtiartikkeleita. Tämä väitöskirjatyö koostuu neljästä esseestä, joissa analysoidaan aineistoa kahden eri teorian, toimijaverkostoteorian (ANT) ja institutionaalisen teorian (NIS), avulla. Tulokset tuovat esille, kuinka kahden teorian (ANT ja NIS) metodologinen käyttö rikastuttaa ja laajentaa näkemystä johdon laskentatoimen muutosprosessista. Esimerkiksi analysoitaessa DRG-järjestelmän yhtenäistä käyttöä tutkimatta toimijoiden toimintaa toimijaverkostoteoriaa hyödyntäen, tulokset voisivat tältä osin olla erilaiset. Erityisesti tämä väitöskirjatyö osoittaa, kuinka tärkeää julkisen sektorin johdon laskentajärjestelmien käyttöönoton muutosprosessia tutkittaessa on tutkia myös toimijoiden toimintaa. Idea DRG-järjestelmästä esitettiin Suomessa melkein kaksikymmentä vuotta sitten. Tulokset osoittavat kuitenkin, että sen leviäminen on ollut hyvin hidasta. Aikaisempien tutkimusten mukaan institutionaalisen ympäristön katsotaan painostavan organisaatioita, jotta ne ottaisivat käyttöön uusia menetelmiä, jotka ovat yhdenmukaiset muiden institutionaalisten käytänteiden kanssa. Suomen hajautetussa terveydenhoidossa esitetään epäsuoraa painetta, mutta sen voima muutokseen ei ole vahva. Väitöskirjatyö tuo esille miten suurien instituutioiden, kuten Suomen terveydenhoidon, vastuun hajautuessa myös reformit hidastuvat ja hajautuvat. Institutionaalisten voimien heikentyessä organisaatioiden voima ajaa asioita näyttää kuitenkin vahvistuvan
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Allen, Miranda. "There's Just No Accounting for Healthcare: A look at the differences between standard GAAP accounting and accounting for healthcare clients." Kent State University Honors College / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ksuhonors1367851476.
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Stainton, Rogers Wendy. "Accounting for health and illness : a social psychological investigation." Thesis, n.p, 1987. http://ethos.bl.uk/.
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Martin, Christopher A. "Accounting for individual choice in public health emergency response planning." Thesis, Kansas State University, 2013. http://hdl.handle.net/2097/16993.
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Master of ScienceDepartment of Industrial and Manufacturing Systems Engineering
Jessica L. Heier Stamm
During public health emergencies, organizations in charge require an immediate and e ffcient method of distributing supplies over a large scale area. Due to the uncertainty of where individuals will choose to receive supplies, these distribution strategies have to account for the unknown demand at each facility. Current techniques rely on population ratios or requests by health care providers. This can lead to an increased disparity in individuals' access to the medical supplies. This research proposes a mathematical programming model, along with a solution methodology to inform distribution system planning for public health emergency response. The problem is motivated by distribution planning for pandemic influenza vaccines or countermeasures. The model uses an individual choice constraint to determine what facility the individual will choose to receive their supplies. This model also determines where to allocate supplies in order to meet the demand of each facility. The model was solved using a decomposition method. This method allows large problems to be solved quickly without losing equity in the solution. In the absence of publicly-available data on actual distribution plans from previous pandemic response e fforts, the method is applied to another representative data set. A computational study of the equity and number of people served depict how the model performed compared to the actual data. The results show that implementing an individual choice constraint will improve the effectiveness of a public health emergency response campaign without losing equity. The thesis provides several contributions to prior research. The first contribution is an optimization model that implements individual choice in a constraint. This determines where individuals will choose to receive their supplies so improved decisions can be made about where to allocate the resources. Another contribution provided is a solution methodology to solve large problems using a decomposition method. This provides a faster response to the public health emergency by splitting the problem into smaller subproblems. This research also provides a computational study using a large data set and the impact of using a model that accounts for individual choice in a distribution campaign.
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Hagist, Christian. "Demography and social health insurance : an international comparison using generational accounting /." Baden-Baden : Nomos, 2008. http://www.gbv.de/dms/zbw/556755847.pdf.
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Hagist, Christian. "Demography and social health insurance an international comparison using generational accounting." Baden-Baden Nomos, 2007. http://d-nb.info/98698468X/04.
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Cravo, Oliveira Tiago. "Accounting for behaviours and context in evaluations of complex health interventions." Thesis, Imperial College London, 2014. http://hdl.handle.net/10044/1/24687.
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Health care systems across developed countries face a perfect storm of rising demand and constrained funding. Systems have relied so far on short-term fixes but the time for incremental piecemeal solutions is passing. To achieve transformational change and fundamental service redesign, policy makers are resorting to ever more complex interventions. Evaluating their effects is far from trivial. From public health programmes, to integrated and community care services, to electronic health technologies, complex health interventions typically exhibit a large number of components and interactions among them and other parts of the system; involve numerous intricate behaviours by those delivering and receiving the intervention; engage multiple and diverse groups, organisational levels and populations; result in many outcomes, typically with a high degree of variability; and are extensively tailored to local settings and circumstances. Evaluating such interventions is as much about whether they work, as how and why. In this research, I examine the difficulties in using standard economic evaluation methods to assess complex interventions in the outpatient setting, and develop an approach to evaluation which uses methods and techniques that can explicitly address complexity, incorporate preferences and behaviours of patients and carers, and account for wider contextual influences. I apply the suggested approach to the evaluation of teleconsultation in Alentejo, drawing on insights from previous theoretical and empirical research, new econometric and statistical studies, and simulation modelling. The application makes contributions to extant research on behaviour and decision making, and has implications for the evaluation of teleconsultation, as well as for broader discussions of how to assess complex interventions. Complex health interventions have the potential to deliver a revolution in health care, but to achieve it we must be able to identify those that truly work, how and why. It is hoped the approach suggested here will contribute to that objective.
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Gifford, Corey. "A Model for a Haitian Comprehensive Community Mental Health Center: An Accounting." Antioch University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1438630721.
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Alamri, Ahmad. "Management accounting change in the Saudi public health sector : a neo-institutional perspective." Thesis, University of Essex, 2016. http://repository.essex.ac.uk/16369/.
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This research has investigated and analysed why and how Management Accounting (MA) has contributed, at the institutional level, to improving Health Care Quality (HCQ) within the Saudi Arabian Public Health Sector (SAPHS). Analysing these developments as a form of change consistent with the dynamics found in the emergence of New Public Management (NPM), this study draws on Neo-Institutional Sociology (NIS). The research studies how MA change operated across institutional contexts within an NPM-based approach to improving health care and public health in the Kingdom of Saudi Arabia (KSA). It focuses on how, in this context, the roles and practices of MA have been defined, designed and implemented to promote ‘quality outcomes’ in health care. Methodologically this has involved two extensive case studies of MA change in two carefully selected hospitals, including semi-structured interviews with accountants, management, consultants and clinicians along with the collection and analysis of key documentary information used in managing the human and financial resources within the hospitals. The findings show how and how far new management accounting practices (MAPs) have promoted the ability and ‘right’ of management to coordinate control and monitor the human and financial resources, but in a way that specifies HCQ outcomes for patients, thus meeting both economic and social/political objectives. It is argued that MAPs had significant success because the allocation of budgetary resources by the Ministry of Health (MOH) was based on hitting non-financial quality and productivity targets. In both hospitals MAPs came to operate within a ‘non-accounting budgetary style’ (Hopwood, 1973) de-emphasising cost control, and managers and staff focussed just on effectiveness and efficiency measures. However, this initiative can also be seen as a response to significant institutional pressures and concerns at both government and professional levels, responding to ‘public voice’ concerns over HCQ. The response drew on world-leading medical research and practitioners to introduce best-practice HCQ solutions allied to internationally accredited quality standards into the KSA hospital sector. The study found that coercive, mimetic and normative isomorphism all contributed to the successful implementation of the HCQ agenda, and the new MAPs here contributed to strengthening the internal and external legitimacy of certain key KSA institutions. There was some institutionally significant resistance from clinicians who saw these MAPs as compromising their professionally-defined focus on quality outcomes for patients. But over time, the mix of ‘soft’ quality and ‘hard’ MA derived targets was increasingly accepted and internalised as integral to delivering HCQ.
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Hassan, Mostafa Mohamed Kamal Mohamed. "The Egyptian health care reform : a case study on resisting management accounting change." Thesis, University of Essex, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248655.
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Harradine, D. "Accounting for negotiated order : a case study of a National Health Service hospital." Thesis, Nottingham Trent University, 2007. http://irep.ntu.ac.uk/id/eprint/9634/.
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Hopwood (1979) made the call for accountancy research to explore the importance of accounting to our understanding of organisations and society. This call has been the basis for this work in that the author has striven to find a way to understand accounting's role in a particular organisation's story. Only by exploring the organisation's story over a considerable time period, a time-span of fifteen years, and in detail has this been achievable. The research has been an ethnographic study based on considerable empirical evidence in a complex public service organisation: the King Charles Hospital Trust. The project has utilised experiences from the workplace and applied considerable rigour to the validity of the data and to its interpretation through grounded theory supporting the recommendation of Parker (1997). It is suggested that this work offers a template for accounting research in public sector organisations to explore the call made by Hopwood. Rahaman and Lawrence (2001) identified the lack of application of the concept of negotiated order as a way of exploring accounting in public sector organisations. This study has adopted this approach to explore the importance of accounting to the modem public service organisation. This project offers a clear contribution to the literature concerning the contribution of accounting to the modem organisation. Firstly the study builds upon existing studies in the area of the role of accounting in organisations and society and utilises the underused negotiated order perspective for the examination. Secondly, the fundamental contribution of the study, is that it develops the concept of the synergistic accounting negotiated order resource which can be used by actors within the organisation to influence the negotiated order of that organisation. This resource is a compendium of roles of accounting and their associated discourses. It is the finding of this study that in the modem organisation position within a negotiated order is enabled with the use of this resource.
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Duke, Caitlin R. "How Healthcare Accounting Adapts to Lean Practices." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/honors/388.
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Healthcare has recently begun a push towards more lean practices and management. Healthcare accounting, in an effort to reflect business practices, must change to accurately reflect reality. This research seeks to explore how healthcare providers improve their accounting systems to keep up with an ever-changing lean environment. By examining both healthcare and accounting literature, this comprehensive literature review seeks to answer the question, “How does healthcare accounting adapt to lean philosophies?”.
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Jones, Ambrose III. "Antecedents and Consequences of Lifestyle Choice in Public Accounting." VCU Scholars Compass, 2007. http://scholarscompass.vcu.edu/etd/1111.
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This dissertation examines the effects of healthy lifestyle of auditors in public accounting as a mitigating influence between role stress and job outcomes (performance, satisfaction, and turnover). Based on coping and self-determination theories, the study was designed to investigate the impact of healthy lifestyle as a coping measure that is within the control of the individual, regardless of firm policies or the firm's work environment.To address the research issues, a survey was conducted of professional auditors employed by a large national public accounting firm with offices located throughout the United States. The sample included 1,026 auditors from various regions of the United States and at various levels in the firm. Structural equation modeling was used to analyze the causal effects of role stressors and healthy lifestyle in a fully-mediated model on job outcomes of performance, satisfaction and turnover intentions.The hypothesized model demonstrated acceptable fit statistics and, generally, the hypotheses were supported. The results indicate that role stress as mediated by job burnout and its effect on psychological well-being will have a negative impact on job outcomes. However, the negative effects of role stress and job burnout can be mitigated by a healthy lifestyle which, mediated by its effect on vitality and psychological wellbeing, is positively related to job outcomes.
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Moore, Joseph. "Radiation therapy treatment plan optimization accounting for random and systematic patient setup uncertainties." VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/218.
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External-beam radiotherapy is one of the primary methods for treating cancer. Typically a radiotherapy treatment course consists of radiation delivered to the patient in multiple daily treatment fractions over 6-8 weeks. Each fraction requires the patient to be aligned with the image acquired before the treatment course used in treatment planning. Unfortunately, patient alignment is not perfect and results in residual errors in patient setup. The standard technique for dealing with errors in patient setup is to expand the volume of the target by some margin to ensure the target receives the planned dose in the presence of setup errors. This work develops an alternative to margins for accommodating setup errors in the treatment planning process by directly including patient setup uncertainty in IMRT plan optimization. This probabilistic treatment planning (PTP) operates directly on the planning structure and develops a dose distribution robust to variations in the patient position. Two methods are presented. The first method includes only random setup uncertainty in the planning process by convolving the fluence of each beam with a Gaussian model of the distribution of random setup errors. The second method builds upon this by adding systematic uncertainty to optimization by way of a joint optimization over multiple probable patient positions. To assess the benefit of PTP methods, a PTP plan and a margin-based plan are developed for each of the 28 patients used in this study. Comparisons of plans show that PTP plans generally reduce the dose to normal tissues while maintaining a similar dose to the target structure when compared to margin-based plans. Physician assessment indicates that PTP plans are generally preferred over margin-based plans. PTP methods shows potential for improving patient outcome due to reduced complications associated with treatment.
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DiLiberto, Deborah D. "Accounting for complexity : an examination of methodologies for complex intervention research in global health." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2017. http://researchonline.lshtm.ac.uk/4645353/.
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Accounting for complexity is now a feature of health interventions research, but it is unclear how this might best be accomplished. As the number of methodologies to account for complexity expands, developing a coherent approach to intervention research has become more urgent and yet more difficult. This thesis aimed to address this challenge by examining methodologies used to design and evaluate complex interventions in global health. Four areas considered central to complex interventions research were explored – intervention design, evaluation of outcomes, assessment of causal mechanisms, and evaluation of context. In each of these areas, a different mixed method, statistical, or qualitative methodological approach was employed following available guidance. Data were drawn from the design and evaluation of the PRIME intervention, a complex health service intervention to improve care for malaria at health centres in rural Uganda. Conceptual and methodological challenges were encountered in each area of investigation. Opportunities for improving each methodological application are suggested alongside an overall recommendation for greater reflection on, and reporting of, the processes and investments necessary for conducting complex interventions research. Additionally, the evidence produced in each area of investigation revealed different, partial and incommensurable accounts of the intervention and its effects. This draws attention to the challenges that can arise when seeking to combine evidence of ‘what works’ with evidence from methodologies that employ different approaches to understanding how interventions are taken up and produce effects. Approaches to accounting for complexity in intervention research need to evolve from focusing on the narrow question of ‘what works’ towards emphasising a more dynamic and multi-perspective question of ‘what happens’. Such an approach may be particularly useful for understanding the multiple and varied effects of complex interventions and their role in improving health and wellbeing.
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Jin, Ruogu. "A Tale of Two Industries: The Impact of Diversification on Financial Health." Scholarship @ Claremont, 2019. https://scholarship.claremont.edu/cmc_theses/2236.
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This paper pioneered in examining the impact of diversification on financial performance of technology companies and comparing diversification and its impact between technology and media companies. Diversification and financial performance in 24 leading media companies and 19 leading tech companies from 2012 to 2017 were studied. The empirical results suggest diversification in general has a positive impact on ROE of tech companies. There is also some evidence for a positive impact from related diversification on ROA of media companies with market cap over $10B. The results also show that media companies are more diversified than tech companies. From 2012 to 2017, both tech companies and big media companies have steadily increased their related degree of diversification while slightly reducing their overall diversification. That seems to suggest that the media and tech conglomerates have increased their effort to create synergy.
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Zargarian, Herand Ron. "CEO Compensation and Performance in Publicly-Traded Hospitals| 2011-2016." Thesis, Northcentral University, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10840268.
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Average compensation of a CEO of publicly-traded hospitals was about $4 million a year for the period 2011 to 2016. Their compensation is growing while people have a hard time to pay the medical bills. The passage of the Affordable Care Act of 2010 has a significant effect on the healthcare system specifically on hospital operations. Hospitals account for 32% of the total healthcare costs. Through the passage of the ACA, lawmakers intended to reduce costs and increase the quality of care. Publicly-traded entities because of the separation of the management (agent) and ownership (principal) have conflicts of interest that lead to agency problems and costs such as the cost of monitoring and low return to shareholders. The publicly-traded hospitals are no exception. Hospitals provide incentives to the CEOs to reduce these costs and align their and shareholders? objectives. The purpose of the quantitative study was to examine the following question. What correlation, if any, existed between CEO compensation and financial performance of the U.S. hospitals post the ACA Act of 2010 for 2011-2016? The following metrics, operating margin, return on assets, return on equity, occupancy rate, length of stay, and profit per discharge, were used to perform multiple regression analysis. Initially, seven hospitals were selected, but one hospital was excluded because of missing data. Spearman?s rho correlation was used because data violated some of the parametric assumptions. The Operating margin, occupancy rate, and profit per discharge variables were statistically significant in explaining the CEO compensation. Other variables affected the CEO compensation but were not statistically significant. Finally, including all six variables explained less than 30% of CEO compensation, which would indicate agency problems exist in the hospitals. Future studies should identify what other variables explain the change in CEO compensations
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Hung, Woan Ting. "Theorising management accounting practices and service quality : the case of Malaysian health tourism hospital destinations." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/39527/.
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Private hospitals in Malaysia are now extending their healthcare services to cater for patients travelling from the global market. These organisations are aggressively gearing themselves up to deliver quality services and to demonstrate quality assurance on their services. Hence, service quality strategies and initiatives have become critical for success in hospitals and the way forward. In pursuing quality initiatives, hospitals need to gain access to quality-related information and adopting the appropriate management accounting practices would be an important enabler and facilitator to generate useful management information leading to organisational successes. This study examines the usage of management accounting practices in these hospitals and attempts to develop a management accounting framework that would effectively facilitate the implementation of service quality initiatives pursued. Structured questionnaire was used to gather the perceptions of hospital management on service quality implementation level, usage level of management accounting practices usage and performance level of hospitals. Quantitative methods using MANOVA and structural equation modelling with AMOS were employed for data analysis. The results show that service quality implementation level was not found to be higher in hospitals that have obtained more types of quality achievements as compared to those that have obtained less or no achievements. Hospitals have benefitted from the implementation of quality initiatives related to management, process and analysis. However, such benefit was not found in quality initiatives related to patient care. In terms of the mediating role of management accounting practices, the results show no mediation effect on the impact of patient care on hospital performance. Meanwhile, there was partial mediating effect on the impact of management, process and analysis on hospital performance. Specifically, the mediating effect was found to be stronger from the advanced accounting practices compared to the basic accounting practices. The findings lead to a conclusion that adopting the appropriate management accounting practices would effectively facilitate hospitals in their quality pursuits. Limitations of this study and recommendation for future research are presented.
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McCulloch, Steven P. "The British animal health and welfare policy process : accounting for the interests of sentient species." Thesis, Royal Veterinary College (University of London), 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.701663.
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Bidour, Jamal Ibrahim. "Introduction of accrual accounting system into the public sector : measuring the health sector performance in Jordan." Thesis, University of Nottingham, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.397719.
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Johnson, Leslie. "A High-Level Overview of How the New Accounting Standard Update on Revenue Recognition Impacts the United States Healthcare System." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/honors/456.
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In May of 2014 the Financial Accounting Standards Board (FASB) and the International Accounting Standards Board (IASB) issued a long-awaited joint updated standard on revenue recognition, ASU 2014-09 – Revenue from Contracts with Customers. While almost all entities will be affected to some extent by the new standard, particularly the changes in required disclosures, this research seeks to examine the impact the new standard will specifically have on the healthcare industry. By highlighting areas of significant challenge a better understanding will be gained of the impact health care service entities will experience as they transition to a new standard.
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Azoulay, Arik. "The use of the transition cost accounting system to compare costs of treatment between Canada and the United States : methodological issues based on the case of acute myocardial infarction." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31186.
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The Transition cost accounting system integrates clinical, resource utilization, and financial information and is currently being used by several hospitals in Canada and the United States (U.S.) to calculate the costs of patient care. The potential use of the Transition system for estimating in-hospital costs in health services research, however, depends on the accuracy of the system's measurements. Thus, the objectives of this thesis were (1) to assess the use of hospital-based cost accounting systems to measure costs of treatment, (2) to identify potential sources of measurement error inherent to the Transition system methodology, (3) to collect audit documentation in order to evaluate the accuracy of the Transition system's information, and to collect cost of treatment data from Canadian and U.S. hospitals in order to illustrate the system's use in health services research, and (4) to discuss the potential use of the Transition system in health services research in Canada and the U.S. (Abstract shortened by UMI.)
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Morgan, Susan Elaine 1967. "Metaphorical messages and the literal-minded: Accounting for individual cognitive differences in the design of persuasive health messages." Diss., The University of Arizona, 1997. http://hdl.handle.net/10150/282312.
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Although metaphor has been a subject of study for centuries, few experimental studies have attempted to demonstrate the persuasive power of messages containing metaphors. Moreover, it is rarely acknowledged that metaphors and analogies can serve as valuable tools to tailor messages to the values of culturally diverse populations. This dissertation outlines the utility of incorporating metaphors and analogies within persuasive messages and advances a method for generating culturally appropriate metaphors and analogies. The literature on the neurophysiological basis of figurative language processing is reviewed in an attempt to uncover the origin of the persuasive power of metaphor. This literature leads to the development of the concept of Literal Mindedness as a way to explain individual differences in responses to figurative language. The Literal Mindedness Inventory is developed as part of this dissertation research, and its convergent validity with Need for Cognition also is established. Finally, an experiment was conducted to test the effect of metaphors and analogies and Literal Minedness on persuasion. To assess the effect of metaphors and analogies on the reception of persuasive health messages (HIV prevention/pro-condom messages), nine messages representing three levels of metaphors and analogies were tested on outcome measures such as fear, efficacy, message evaluation, and knowledge and attitudes. The hypotheses advanced in this study were partially supported, and form the basis of a number of recommendations for future research.
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Slyter, Mark F. "How well do hospitals budget operating results? The relationship between budget variances and operating margin." Thesis, The University of Alabama at Birmingham, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10246287.
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There is a near-universal assumption in both practice and literature that greater accuracy and management to the budget improves profitability (Libby & Lindsay, 2010; Umapathy, 1987). Prior to this study, this assumption has gone untested and we know little about the wisdom of such an assumption.
The results of this study indicate greater accuracy in forecasting and/or tighter management to the budget, or favorably exceeding it, leads to improved profitability. More specifically, smaller unfavorable budget variances are associated with greater operating margins while greater favorable budget variances are associated with greater operating margins. A single standard deviation reduction in unfavorable revenue and expense increases operating margin by 5.2% and 6.3%, respectively. An equivalent favorable deviation in revenue and expense increases operating margin by 3.2% and 2.7%, respectively. Managers can improve hospitals’ operating margins by first prioritizing the reduction and/or eliminating unfavorable variances, and second increasing favorable variances.
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Du, Toit Elda. "Using financial analysis and interpretation as a foundation to comprehend financial health." Thesis, University of Pretoria, 2012. http://hdl.handle.net/2263/24645.
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The ability to measure the financial health of a company is becoming an increasingly serious issue. One only needs to think of the widely published irregularities in companies such as Enron, Parmalat and Macmed to grasp something of the magnitude of the losses and other problems that investors can face if they do not have the ability to “predict” possible problems. There are individuals who are constantly identifying new and ingenious ways to deceive their customers, investors, the government and others. It is important for parties with an interest in a company to devise new ways to identify how financial analyses can be used to protect their interests. Managers are primarily responsible for the prevention and identification of accounting irregularities. Unfortunately, at the same time, they may also be assumed to be the primary perpetrators of accounting irregularities, because they are in a position to manipulate accounting records and bypass control measures more easily than anyone else in a company. The main aim of this study is to determine whether financial analysis and interpretation can be applied by interested parties to measure financial health and by implication identify accounting irregularities. Proof that this is possible has the potential to be used in analyses, by all parties with an interest in a company, to determine financial health and to identify irregularities in the financial statements. The study begins with a literature review, which provides an explanation of accounting irregularities and related matters, as well as an overview of previous uses of financial analyses to determine whether such analyses are useful in the identification of irregularities in the financial statements. The objectives of the study are as follows: - An investigation into the characteristics, as identified by researchers locally and abroad, that are displayed by companies with a higher risk of or occurrence of accounting irregularities.
- A survey of the media by means of a literature review to identify case study companies that had allegations of accounting irregularities against them.
- The analysis of the case study companies in a quantitative and qualitative way to determine whether the characteristics that are identified as part of the first objective hold true in practice.
- Statistical analyses of the share price data of the case study companies in the form of an event study, a regression analysis and a structural break analysis to determine when and under what circumstances significant changes happened.
- Conduct a survey involving the creators and the users of financial statements in order to observe their experience regarding the usefulness of financial statements to reveal financial health. This is done by means of questionnaires that are analysed statistically, designed to derive conclusions of what practitioners tend to experience in practice and what their feelings are regarding the use of financial statements and accounting data in an analysis of the financial health of a company.
Thesis (DCom)--University of Pretoria, 2012.
Financial Management
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Pflueger, Dane. "Accounting for quality : the emergence and significance of managing for quality in healthcare." Thesis, London School of Economics and Political Science (University of London), 2013. http://etheses.lse.ac.uk/799/.
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This thesis investigates the emergence and significance of the phenomenon termed the contemporary promise of quality in healthcare. This phenomenon is shown to be part and product of a historically extraordinary set of movements that have remade quality in a form that is explicit, calculable, expressible as accounting numbers, and amenable to management ideas and ideals. It is also shown to be closely inter-twined with the emergence of a distinct way of contemplating and undertaking reform of the healthcare sector; a politically attractive means of continually responding to failures by calling for the import of the newest improvement interventions. This thesis documents the historical specificity of these movements and tracks their international reach. It also investigates what the phenomenon entails for healthcare systems, organizations, professionals and patients as it is variously operationalized. Investigating the USA and UK health reforms, and experiences with reform, in detail, this thesis shows that this phenomenon is closely connected with a movement of care activities ‘onto the balance sheet’ and toward representational activities rather than the activities that historically constituted the practices of caring. It also shows this phenomenon to be closely connected with changing forms of expertise, knowledge and professionalism in healthcare. It identifies, for example, the emergence of knowledge about managing experiences, and a certain style of engaging with numbers and acting in an outwardly entrepreneurial way, as closely intertwined with this movement. This thesis as a whole, by attending to the wider movements of which quality and its calculations are part and product, contributes to our understanding of accounting, quality, healthcare, professionalism, and government reforms. It shows the way that a calculable quality emerged and moved between time and place, and in the process reconfigured the very nature of policy-making and caring.
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Perchoux, Camille. "Accounting for residential and non-residential environments to measure contextual effects on health behavior : the case of recreational walking behavior." Thesis, Paris 6, 2015. http://www.theses.fr/2015PA066593/document.
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Les études portant sur les effets de l'environnement sur la santé ont essentiellement examiné les effets de l'environnement résidentiel. Cette approche a été critiquée pour son absence de prise en compte des environnements géographiques de vie non-résidentiels. L'objectif général de cette thèse est d'évaluer si la prise en compte des lieux d'activité dans lesquels les individus se déplacent et sont régulièrement exposés permet de mieux estimer l'impact de l'environnement sur la pratique de la marche récréative. Trois études transversales ont été conduites sur la seconde vague de la Cohorte RECORD. La première étude a permis d'identifier une typologie des comportements de mobilité individuels et les déterminants sociodémographiques de ces mobilités. Les résultats de la deuxième étude montrent que l'exposition à des caractéristiques environnementales facilitant la marche diffère entre le quartier de résidence, le quartier résidentiel perçu, et l'espace d'activité. L'erreur de mesure liée à la seule prise en compte de mesures d'exposition résidentielle varie en fonction des groupes socio-économiques et des degrés d'urbanisation de la résidence dans la région Île-de-France. Dans la troisième étude, une densité de destinations élevée, la présence de lacs ou de voies d'eau et un niveau d'éducation élevé du quartier sont associés à une augmentation de la pratique de la marche récréative. Cette thèse souligne l'importance de prendre en compte les environnements géographiques de vie résidentiels et non-résidentiels pour mieux approximer l'exposition environnementale réelle, et évaluer les effets de l'environnement sur les comportements de santéPrevious studies on place effect on health focused on the residential neighborhood. This approach was criticized for not considering non-residential geographic life environments. The overarching aim of this dissertation is to estimate whether accounting for people’s network of activity places and their resulting exposure allows improving the understanding of environmental influences on recreational walking behavior. Three cross sectional studies were conducted on the second wave of the RECORD Cohort Study. In the first study, I identified a typology of individuals’ patterns of mobility and related socio-demographic correlates. Results from the second study provide evidence that exposure to environmental characteristics supportive to walking highly differs between the residential neighborhood, the perceived residential neighborhood and the activity space. The measurement error resulting from the sole use of residential measures of exposure varies among SES groups and among categories of the degree of urbanicity of the residence. In the third empirical study a high density of destinations, the presence of a lake or waterway, and a high neighborhood education are associated with recreational walking. This dissertation strengthen the conceptual grounds and empirical evidence that accounting for both residential and non-residential geographical environments individual get exposed is required to better proxy the true environmental exposure, and to estimate environmental influences on health behaviors
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Cheung, Nga. "Accounting for and managing risk in sex work : a study of female sex workers in Hong Kong." Thesis, Royal Holloway, University of London, 2012. http://repository.royalholloway.ac.uk/items/1f9e8dcf-7666-1fe1-5036-0f9fef15b9d0/9/.
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This thesis considers how in the course of their work female sex workers in Hong Kong experience risk. It concerns the indoor side of the sex market, an area which has so far been largely ignored in studies on commercial sex. The focus is on women working independently from flats. Focusing on women's own accounts of work-related risks, risky behaviour and coping strategies, this study investigates sex workers' reflexive understandings of prostitution and their occupational risk in late modern societies. The study emphasises the social, cultural, interactional and situational context, to understand the ways in which women involved in sex work conceptualise and respond to risk. There are three main themes emerge in sex workers' accounts. The first one is sexual health and diseases. In this empirical chapter, the main focus is on the flat-working women's accounts of themselves and their risk-taking (or risk-avoiding) behaviour in (potentially) risky situations, where, for example, unprotected sex has occurred. The findings suggest that, despite sex workers are being frequently seen as most susceptible to sexual health problems, the social norms which exist among sex workers and their clients play a crucial role in enabling sex workers to gain control over the sexual encounter and avoid risk behaviour. The next theme is violence against sex workers. Findings suggest that what violent crime symbolises in the context of sex work is that some women are beneath contempt because of their working identity. It is more “acceptable” to perpetrate violence against sex workers because this group is set apart from women in other service occupations. The last theme is concerned with sex workers' accounts of their emotional experiences at work, which mainly explores how social and cultural factors influence individuals' interpretation and accounts of their emotions. Accounts given by women demonstrate that many of them seemingly did not conceive their involvement in the sex business as “wrong”. Nevertheless, because sex work is still largely marginalised and stigmatised in Chinese societies, they might experience unpleasant emotions which were mostly related to the “whore” stigma.
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Zorita, Paz Mendez-Bonito. "Family functioning, life events, and depression: Accounting for contamination of family functioning measures by depression variables, and error of measurement in life events measures." Case Western Reserve University School of Graduate Studies / OhioLINK, 1991. http://rave.ohiolink.edu/etdc/view?acc_num=case1059416374.
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Cordery, Carolyn Joy. "Dimensions of accountability : voices from New Zealand primary health organisations : a thesis submitted to the Victoria University of Wellington in fulfilment of the requirements for the degree of Doctor of Philosophy in Accounting /." ResearchArchive@Victoria e-Thesis, 2008. http://hdl.handle.net/10063/583.
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Etmannski, Tamara R. "Accounting for sustainability in Bengal : examining arsenic mitigation technologies using Process Analysis Method." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:349d4c46-1259-49c1-be2b-46f2cb394894.
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This thesis shows how the Process Analysis Method (PAM) can be applied to assess technologies used to mitigate arsenic from drinking water in rural India, using a set of sustainability indicators. Stakeholder perspectives, gathered from a fieldwork survey of 933 households in West Bengal in 2012, played a significant role in this assessment. This research found that the ‘Most Important’ issues as specified by the technology users are cost, trust, distance from their home to the clean water source (an indicator of convenience), and understanding the health effects of arsenic. It was also found that none of the ten technologies evaluated are economically viable, as many do not charge user-fees, which creates reliance upon donations to meet recurring costs. Utilisation of a technology is strongly related to sociocultural capital, but in many cases, features that contribute to sociocultural value, like regular testing of the treated water, are not included in the financial budget. It is suggested that increased awareness might change attitudes to arsenic-rich waste and its disposal protocols. This waste is often currently discarded in an uncontrolled manner in the local environment, giving rise to the possibility of point-source recontamination. All technologies proved to have difficulties in dealing with waste, except the Tipot and Dug wells which produce no waste. Of the methods considered, the BESU technology scored highest, but still only with 47-62% of the maximum scores achievable within each domain. This explains the widespread failure of mitigation projects across the region. The indicators and metrics show where improvements can be made. A model scheme based on these findings is outlined which could be applied with the objective of increasing utilisation and improving sustainability. It can be concluded that a product stewardship approach should be taken in regard to design, implementation and operation of the technologies, including the creation of a regulated toxic waste collection and disposal industry.
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Lincoln, M. G. "The impact of economic rationalism and new public management on health and welfare services : accounting for the gap between social health care policy and practice in two Scottish maternity care units." Thesis, University of Edinburgh, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.653919.
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The administration of welfare in Britain and beyond, in the last thirty years, has seen a series of changes culminating into the new public management (NPM) approach in the delivery of public services. Current literature suggests that traditional collectivist values underlying state welfarism are at risk under the precepts NPM and economic rationalism (Hood 1991; Clarke and Newman 1997; Hunter 2002). Selecting decentralised budget management as one key aspect of NPM, this thesis tests out its impact on two key policy recommendations, ‘service user choice’ and ‘continuity of care’ as set out by the Cumberledge Report (1993). The design of the enquiry consists of a merger of two opposite methodological approaches: questions put to participants are informed by a NPM framework; at the same time, the openness of the interview schedule also allowed, in part, the inclusion of a grounded theoretical approach, characteristic of Glaser and Strauss (1967). The study took place in Scotland where two highly contrastive maternity units, in terms of size, internal culture and geographical location, were investigated. Tape-recorded in-depth interviews, of around 45-90 minutes each, were carried out with a sample of 43 consultant obstetricians, junior doctors, paediatricians, midwives, and key financial management personnel. The comparison of the two sites highlights how organisational size, structure and the midwifery system in place can impinge on the viability and implementation of social health policies such as those recommended in Changing Childbirth. Whilst economic rationalism has hampered the full expression of service user choice and continuity of care owing largely to inadequate staffing or practitioner skills, the dictates of new public management have had a more turbulent impact on the larger than on the smaller unit. One contribution of this thesis is the finding that service user choice is not only constrained by economic rationalism but by internal institutional agendas as well - a consideration, which, to a certain extent, is likely to be applicable to all health and welfare services. Another key contribution is the identification of the distinct forces that combine to obstruct the implementation of social health policies. Apart from complex economic, organizational and institutional influences, one significant obstructing influence is the obstetricalisation of childbirth. The gap between social health policy and practice is widening further as mergers take precedence over the retention of smaller, relatively low-tech maternity care units. This structural change that is aimed at fulfilling the perceived needs of ‘medical safety’ is increasingly likely to render Changing Childbirth recommendations into impracticable propositions. The thesis concludes that a comprehensive approach towards health and welfare, where service user choice and continuity of care are recognised, and which considers the social context in which economic action takes place is expected to lead to improved health and welfare and outcomes overall.
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Bäck, Linda, Robin Sittkoff, and Lisa Westerberg. "Hälsobokslut : En studie av tre landsting." Thesis, Jönköping University, JIBS, Business Administration, 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-74.
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Hälsobokslutet är ett relativt nytt begrepp som härstammar från flera olika redovisningsläror. På grund av den höga sjukfrånvaron i Sverige har regeringen utformat en handlingsplan med syfte att minska ohälsan. En del i denna handlingsplan är den om hälsobokslut. Syftet med hälsobokslutet är att företagen ska bli mer medvetna om den hälsostatus som råder på arbetsplatsen och utifrån det genomföra hälsorelaterade åtgärder.
Syftet är att beskriva två olika hälsobokslutsmodeller och sedan jämföra tre genomförda hälsobokslut sinsemellan samt med modellerna. Syftet är även att klarlägga implementeringsarbetet och utröna om hälsoboksluten lett till några effekter i landstingen.
För att få en förståelse för begreppet hälsobokslut och kunna besvara uppsatsens syfte används den kvalitativa metoden. Jämförelserna av både modellerna och hälsoboksluten har skett genom litteraturstudier och granskning av de upprättade boksluten. För att kunna fullfölja den klarläggning som förutsätts i syftet har vi genomfört intervjuer med de valda landstingen.
De jämförelser som gjorts mellan hälsobokslut och modeller visar att hälsoboksluten skiljer sig på mycket få punkter från modellerna. Vad gäller jämförelserna mellan hälsoboksluten i de tre landstingen är de största likheterna att de alla kräver samarbete och är beroende av fungerande personaladministrativa system. De största skillnaderna mellan boksluten är omfattningen och antalet verksamheter det implementerats i. Implementeringsarbetet har varit olika svårt för de tre landstingen och svårigheterna har bestått i både tekniska problem och bearbetning av stora mängder information. Hälsobokslutet har lett till positiva effekter på sjukfrånvaron och ökat personalengagemang.
Health account is a rather new concept that originates from several different schools of accounting. Due to the high number of sick leaves in Sweden, the government has developed a document with the purpose of reducing the sick leave and the health account is a part of this plan. The purpose of the health account is to make companies and organisations more aware of issues concerning health in the workplace. From this point it is possible to take steps against illness.
The purpose is first to describe two different health account models and then compare them to three completed health accounts. The purpose is also to examine the implementation process and to find out if the health accounts have lead to any effects in the county councils.
To create an understanding for the expression health account, and to be able to answer the purpose of our thesis, we have used a qualitative method. Both the comparison of the models and the health accounts were realised through studies of literature and reviews of the health acounts. To be able to accomplish the clarification that was given in the purpose, we have conducted interviews with the selected county councils.
Those health accounts that we have studied shows that they differ very little from the models. When it comes to the comparison between the health accounts, the main similarities are that they all require cooperation and they are dependent of well working personal administration systems. The main difference between the health accounts is to what extent they have been implemented in the organisation. The difficulties concerning the implementation have varied between the three county councils. The difficulties concern both technical problems and to handle large amounts of information. The health accounts had positive effects on sick leave and has also increased the interest in questions concerning the employees.
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Adomako, Godfred. "Strategies in Mitigating Medicare/Medicaid Fraud Risk." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3738.
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In the fiscal year 2014, approximately 1,337 health care providers lost their provider license to Medicare/Medicaid fraud. Out of the 1,318 criminal convictions reported by the U.S. Medicaid Fraud Control Units (MFCU), 395 (30%) were home health care aides who claimed to have rendered services not provided. The purpose of this multiple case study was to explore licensed and certified home health care business managers' strategies to mitigate Medicare/Medicaid fraud risk. A purposive sampling of 9 business managers and chief executive officers from 3 licensed and certified home health care businesses in Franklin County, Ohio participated in semistructured face-to-face interviews. Data from the interviews were transcribed, coded, and analyzed to identify themes regarding Medicare/Medicaid fraud risk management strategies. Drawing from the Committee of Sponsoring Organization's internal control framework and fraud management lifecycle theory, 5 themes emerged: the control environment, risk assessment, control activities, information and communication, and monitoring activities. Findings from this study included maintenance of integrity and culture, training and educating both staff and clients about fraud reporting processes and the consequences of fraud, rotating staff on a regular basis, performing fraud risk assessments, implementing remote timekeeping and monitoring system, and compensating shift leaders to coordinate activities in the clients' residences. The implication for positive social change includes reducing healthcare cost for all taxpayers through Medicare/Medicaid fraud reduction.
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Argüello, Velazquez Jazmin Adriana. "Implementing Ecosystem Natural Capital Accounting Methodology to the Rhone watershed : the proof-of-concept." Thesis, Lyon, 2019. http://www.theses.fr/2019LYSEN040/document.
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Comment mesurer la dégradation de la nature, son état de "santé", afin de déterminer l’amortissement de son utilisation, non-enregistré dans les bilans des nations? Mon travail de thèse sur la « comptabilité écosystémique » du bassin versant du Rhône est une première expérimentale sur une nouvelle méthodologie intégrable aux outils encore incomplets des comptabilités nationales de type PIB. Consommer du capital écologique, nos ressources renouvelables, sans l’amortir revient à créer des dettes écologiques. L’objectif de la comptabilité écosystémique est de produire un outil d’aide à la décision permettant d’éviter la dégradation nette des écosystèmes par des politiques publiques informées par la science. L’outil produit des bilans écologiques basés sur des informations géographiques et mesurés en termes physiques, permettant d’effectuer des modélisations et simulations afin d’estimer l’internalisation des externalités (Figure). J’ai élaboré divers indicateurs synthétiques relatifs aux fonctions des écosystèmes et de leur intégrité, pour calculer le potentiel écologique du bassin versant du Rhône. Le diagnostic comptable est assortie d’une description spatialisée des changements observés afin de mieux saisir leur pertinence. L’outil est susceptible d’aider les différentes entités territoriales à se positionner sur la gestion de leurs ressources renouvelables stratégiques (eau, sols, biomasse, infrastructures et services écologiques) dans le contexte d’un ordre mondial en transformation: il s’agit des enjeux géopolitiques majeurs en matière de sécurité et souveraineté alimentaire et énergétique, dans leur lien avec la santé publiqueHow to measure the degradation of nature, its "health" condition, to determine the depreciation of its use, not recorded in the balance sheets of the nations? My thesis work on the "ecosystem accounting" of the Rhone river basin is an experimental first on a new methodology integrable with the still incomplete tools of the national accounts of the type GDP. Consuming ecological capital, our renewable resources, without amortizing means the creation of ecological debts.The goal of ecosystem accounting is to produce a decision support tool to avoid the net degradation of ecosystems through science-informed public policies. The tool produces ecological balances based on geographical information and measured in physical terms, making it possible to perform modelizations and simulations in order to estimate the internalisation of externalities (Figure). I have developed various synthetic indicators relating to the functions of ecosystems and their integrity, to calculate the ecological potential of the Rhône watershed. The accounting diagnosis is accompanied by a spatial description of the changes observed in order to better understand their relevance. The tool is likely to help the various territorial entities to position themselves on the management of their strategic renewable resources (water, soil, biomass, infrastructures and ecological services) in the context of a changing world order: major geopolitical issues in terms of security and food and energy sovereignty, in their link with public health
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Schneider, Eric B. "Studies in historical living standards and health : integrating the household and children into historical measures of living standards and health." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:f2e55a37-c605-4aba-8a2e-3d699c6b82b7.
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This dissertation attempts to integrate the household and children more fluidly into measures of well-being in the past. In part one, I develop a Monte Carlo simulation to test some of the assumptions of Allen’s welfare ratio methodology. These included his assumptions that family size was constant over time, that there were no female-headed households and that women and children did not participate in the labour force. After all of the adjustments, it appears that Allen’s welfare ratios underestimate the welfare ratios of a demographically representative group of families, especially if women and children’s labour force participation is included. However, the predicted distributions also highlight the struggles of agricultural labourers, who are given separate consideration. Even the average agricultural labourers’ family with women and children working would have had to rely of self- provisioning, gleaning, poor relief or the extension of the working year to make ends meet at the poorest point in their family life cycle. Part two adjusts Floud et al.’s estimates of calorie availability in the English economy from 1700 to 1909 for the costs of digestion, pregnancy and lactation. Taken together, these three additional costs reduced the amount calories available by around 15 per cent in 1700 but only by 5 per cent in 1909 because of the changing composition of the English diet. Part three presents a new adaptive framework for studying changes in children’s growth patterns over time and a new methodology, longitudinal growth studies, for measuring gender disparities in health in the past. An adaptive framework for understanding growth provides a more parsimonious explanation for the vast catch-up growth achieved by slave children in the antebellum American South. The slave children were only able to achieve this catch-up growth because they were programmed for a tall height trajectory by relatively good conditions in utero. Finally, impoverished girls experienced greater catch-up growth than boys in two schools in late-nineteenth century Boston, USA and early-twentieth century London, suggesting that girls were deprived relative to boys before entering these institutions.
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Svoboda, Michal. "Reforma účetnictví státu jako předpoklad ekonomického rozhodování externích uživatelů účetních výkazů obcí." Doctoral thesis, Vysoká škola ekonomická v Praze, 2008. http://www.nusl.cz/ntk/nusl-165894.
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This dissertation thesis analyzes gains of the governmental accounting reform in the Czech Republic in terms of increase in relevance, usability and accessibility of the economic data in the public sector of the Czech Republic, especially in municipalities. It identifies some risks that have arisen from this reform and offers some ways to eliminate them. The existence of the public sector itself is also explained as well as the existence of users of economic information of the public sector. It involves a comprehensive description of the reform of public sector financial reporting. A construction of a municipalities' financial health index is also included as a useful tool for increasing understandability and to become the decision making process of users (tax payers) at a higher level. This index is applied on 6 201 municipalities in the Czech Republic as of December 31, 2012.
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Källås, Stefan, and Li Stridh. "Friskvård som framgångsfaktor." Thesis, University of Gävle, Department of Business Administration and Economics, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-4528.
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De flesta är överens om medarbetarnas viktiga roll i ett företag. Det är personalen som kan påverka företagets ekonomiska situation, då personalens välmående på arbetsplatsen påverkar företagets lönsamhet och effektivitet. Många ställer sig frågan varför inte personalen tas upp i redovisningen? Den här uppsatsens syfte är att undersöka vad som gjorts inom redovisning av personalhälsa samt diskutera en ny infallsvinkel i arbetet med hälsa i företag.
Most people do agree about the employee’s important role in a company. It is the workers who can influence the companies’ economic situation, when the personnel’s well-being effects the companies’ profitability and efficiency. Many people ask the question why not the employee’s are reported in the company’s account. The aim of this paper is to investigate what have been done in the area of health accounting and discuss a new approach in the work with health care in companies.
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Cardoso, Ricardo Lopes. "Regulação econômica e escolhas de práticas contábeis: evidências no mercado de saúde suplementar brasileiro." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/12/12136/tde-18122008-121952/.
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A presente pesquisa investiga os impactos da regulação econômica nas escolhas de práticas contábeis. Buscando identificar a relação existente, são apresentadas pesquisas em gerenciamento da informação contábil (de resultado e do balanço patrimonial) e as teorias econômicas da regulação. Em seguida, são apresentadas as evidências empíricas de como a regulação econômica incentiva a adoção de determinadas práticas contábeis. Nesse mister, é apresentada a regulação financeira exercida pela Agência Nacional de Saúde Suplementar (ANS) sobre as entidades operadoras de planos de assistência à saúde (OPS), também chamadas de planos de saúde. Essa regulação financeira consiste no acompanhamento, pela ANS, da situação econômico-financeira das OPS. A ANS compara os índices calculados a partir das informações contábeis recebidas, eletronicamente, das OPS, com parâmetros estabelecidos a priori. Se determinada OPS não atender, satisfatoriamente, os parâmetros, fica sujeita ao afastamento de seus administradores de suas funções e até à liquidação de seus ativos. Por fim, as teorias da regulação e do gerenciamento da informação contábil são revisitadas à luz da Nova Economia Institucional, identificando-se, portanto, a Contabilidade como parte integrante de um contrato (regulação) cujos custos são diferentes de zero (custos de transação), de forma que a informação contábil é a cola que mantém a firma unida e a regulação financeira em atividade.This study analyzes how the economic regulation impacts on accounting policy choices. With a view to identifying the existing relationship between both, the economic theories of regulation and research on earnings and balance sheet management are discussed. Then, empirical evidence is presented of how economic regulation stimulates the choice of certain accounting policies, related to the Brazilian Health Care Agencys (ANS) equivalent to the US Federal governments Office of Health Maintenance Organizations financial regulation of health maintenance organizations (HMO), called OPS in Brazil. OPS have their economic-financial situation monitored by the ANS, which compares the indices calculated on the basis of electronically received financial information with some previously established financial thresholds. If these are not complied with to a reasonable extent, this may lead to the HMOs liquidation. Finally, the regulation and earnings and balance sheet management theories are discussed under the lens of New Institutional Economics, which sees Accounting as part of a contract (regulation), whose costs are positive (transaction costs), and accounting information as the glue that keeps the firm together and keeps the financial regulation working.
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Falisse, Jean-Benoît. "The community governance of basic social services in fragile states : health facility committees in Burundi and South Kivu, DR Congo." Thesis, University of Oxford, 2016. https://ora.ox.ac.uk/objects/uuid:6e81e494-f01f-4df6-a934-3acd7e2c20f0.
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In many low-income and 'fragile' states, citizens' committees are elected to co-manage basic social services. However, the effects of such committees on service delivery, and the way they are influenced by local contexts, remain understudied. This thesis seeks to fill these gaps by examining the case of the health facility committees in Burundi and South Kivu between 2011 and 2014. It relies on original health facility and committee surveys, household surveys, nested interviews and focus groups, and interviews with key informants. The thesis firstly explores how the committees came about. It then looks at the questions, What makes them get involved in decisions at their health facility? and, How do measures designed to improve committee functioning lead to changes in service delivery, if at all? Mixed-methods work finds that chief nurses largely dominate the health facilities, and the committees appear to be both the product of recent political and administrative changes and a façade of community governance. The work's randomised controlled trial tests the idea that this inefficiency arises from an 'institutional knowledge gap': the committee members and nurses do not know the committee's (official) functioning. An information session has strengthened the committees and led to changes in health facility management in South Kivu, but not in Burundi. This difference seems to come from dissimilar management structures and people's relationships to service providers. The intervention has had no effect on service provision. The remaining chapters report on additional interventions in Burundi, which theory and qualitative research suggest might improve the effects of the knowledge intervention: trust-building between nurses and committee, information about health facility performance, and increased interaction between local leaders and committees. These are either ineffective or have unintended consequences. Overall, the thesis nuances the promises of social accountability mechanisms and stresses the importance of power relationships within basic social services.
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Chang, Kathryn J. "The Influence of Ownership on Hospital Board Governance and Strategic Cost Management." University of Toledo / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1382895790.
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Dainytė, Aistė. "Asmens sveikatos priežiūros įstaigos paslaugų savikainos kalkuliavimo modelis." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2013. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2013~D_20130605_160145-59655.
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Darbo tikslas. Pritaikyti N ligoninės bendrosios apskaitos sistemą paslaugų savikainos skaičiavimui.
Uždaviniai: Išanalizuoti ASPĮ finansavimo būdus ir jų sąsajas su sąnaudų įvertinimu; Aptarti ASPĮ valdymo apskaitos sistemas ir parinkti tinkamą savikainos kalkuliavimo modelį; Atlikti ASPĮ paslaugų savikainos kalkuliavimo modelio realizaciją N ligoninėje; Įvertinti savikainos modelio taikymo galimybes ir perspektyvas.
Tyrimo metodika. Tyrimo objektas - N ligoninės bendroji apskaitos sistema. Atlikta mokslinės literatūros analizė ir sintezė; taikytas matematinio modeliavimo metodas – sukurtas tiesinis daugelio lygčių modelis; modelio realizacijai naudoti N ligoninės 2010 metų duomenys (ligoninės veiklos rezultatų ataskaitos, operatyvinės apskaitos duomenys iš „Visma business“, „Alga“ programų ir “Sveidros“ duomenų bazės.
Tyrimo rezultatai. Parinktas pakopinis savikainos kalkuliacijos modelis, realizuotas EXCEL bazėje. N ligoninės padaliniams atidarytos virtualios sąskaitos, kai kuriais atvejais sukurti sąnaudų centrai. Apskaičiuota klinikinių padalinių pilnoji, o kitiems padaliniams nepilna savikaina.
Išvados:
1. ASPĮ paslaugų apmokėjimo įkainiai teoriškai grindžiami paslaugų teikimui reikalingomis sąnaudomis. Tačiau praktikoje paslaugų kainos (įkainiai) labiau atspindi biudžeto galimybes bei santykius tarp įvairaus sudėtingumo DRG grupių nei realias gydymo įstaigų sąnaudas.
2. Universalios išlaidų klasifikacijos sistemos nėra. Kiekvienos įstaigos vadovybė numatydama... [toliau žr. visą tekstą]Aim of the study. To adapt Hospital’s N accounting system to service unit costing. Objectives: To analyze hospital funding methods and their correlation with cost evaluation; To discuss hospital management accounting systems and select the suitable model of service unit costing; To implement the model of service unit costing in the hospital N; To evaluate the possibilities and prospects of implementation of service unit costing model. Methods. The object of the research was the accounting system of hospital N. The scientific literature was analyzed; the mathematical modeling method was applied – the model of most linear equations was developed; the implementation of service unit costing model was based on hospital’s N 2010 year data (reports of hospital’s activity results, operational accounting data taken from “Visma business” and “Alga” programs, “Sveidra” data base. Results. Step-down method for service unit costing was selected and implemented in Excel base. Virtual accounts were opened for hospital’s N departments. In some cases, cost centers were created. Full costing was made for clinical departments, while marginal costing was prepared for the other hospital departments. Conclusions: 1. The tariffs for hospital services are theoretically based on necessary costs of service provision. However, in practice, prices (tariffs) of hospital services reflect budget possibilities and relations between various diagnosis related groups rather than factual hospital costs... [to full text]
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Forney, Robert S. Jr. "The Affordable Care Act and Its Impact on the Professional Tax Preparation Market in Kingsport, Tennessee." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/honors/206.
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The objective of this study is to test whether the Affordable Care Act will have an effect on the professional tax preparation industry of Kingsport, Tennessee. To accomplish this objective, the researcher collected surveys concerning taxpayers’ initial reaction to the realization that the law affects their 1040. A two proportion test for equality was performed and failed to reject the idea that the ACA will have an effect on the tax preparation industry of Kingsport. Because this study failed to prove that the change in legislation causes a jump in clientele for the professional tax preparation market, the fight for market share falls to marketers. They will decide who will benefit from this landmark piece of legislation.
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ASSUNÇÃO, Marcone César Tabosa. "Análise de custos de um serviço de práticas integrativas e complementares no município de João Pessoa – Paraíba." Universidade Federal da Pernambuco, 2016. https://repositorio.ufpe.br/handle/123456789/18755.
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DISSERTAÇÃO- MARCONE CÉSAR.pdf: 558340 bytes, checksum: 9131e22b068f3e78d4c32c535be29c1c (MD5)Made available in DSpace on 2017-05-09T19:57:17Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) DISSERTAÇÃO- MARCONE CÉSAR.pdf: 558340 bytes, checksum: 9131e22b068f3e78d4c32c535be29c1c (MD5) Previous issue date: 2016-07-28
As Práticas Integrativas e complementares (PICs) são utilizadas para prevenção, cura e reabilitação de doenças desde os primórdios da humanidade, durante muitos anos seus conhecimentos eram repassados entres gerações de maneira empírica. Atualmente a formalização de tais práticas é uma realidade, com isso faz-se necessário a utilização de instrumentos capazes de subsidiar a implantação dessas práticas no Sistema Único de saúde (SUS), que é caracterizado por escassez de recursos e demanda ilimitada. A contabilidade de custos pode proporcionar direcionamento orçamentário para essa área. O objetivo do estudo foi analisar os custos do serviço de PICs Equilíbrio do Ser, que se localiza na cidade de João Pessoa-PB e fornecer conhecimento dos custos de um serviço dessa natureza, com o intuito de subsidiar gestores e profissionais de saúde na tomada de decisão. Trata-se de um estudo de caso, sendo caracterizado como uma avaliação econômica do tipo parcial, com caráter descritivo, de natureza quantitativa. Os dados foram coletados por meio de informações secundárias e agrupados em planilhas do Excel. O método utilizado para analisar tais custos foi o de custeio por absorção. A análise dos dados mostra que houve 34.521 atendimentos em 2014 e o custo total do serviço foi estimado em R$ 1.270.015,70, desse montante, 79,69% foram classificados como custos diretos. O custo médio por paciente neste período foi R$ 34,78, considerando práticas individuais e coletivas. Conclui-se que o serviço apresenta um custo alto por paciente em detrimento de serviços biomédicos. O que pode ser considerado um risco para a plena implantação e manutenção da Política Nacional de Práticas Integrativas e Complementares. O resultado da avaliação do custo precisa considerar o modo de abordagem integral e holístico adotado no campo das práticas integrativas. Estudos sobre custoefetividade podem contribuir para ampliar e contextualizar as características do cuidado em saúde no campo das PICs.
Analysis of costs Integrative Practices and Complementary Service in the city of João Pessoa, Paraíba. Integrative and complementary practices (ICPs) are used for prevention, cure and rehabilitation of diseases since the beginnings of humanity. For many years this knowledge was passed on among generations empirically, however formalization of such practices is a reality nowadays. Thus, it is necessary to use instruments to support implementation of these practices in Sistema Único de Saúde (SUS - Brazil’s National Health System). Accounting costs can provide budgetary guidance for this area, considering SUS is characterized by scarce resources and unlimited demand. The aim of the study was to analyze costs of Equilíbrio do Ser, a ICP service located in the city of João Pessoa-PB, and provide knowledge of costs involved, in order to support managers and health professionals in decision making. This is a case study, characterized as a partial economic evaluation, with descriptive and quantitative variables. Data were collected through secondary information and grouped in Excel spread sheets. These costs were analyzed by absorption costing. Data analysis demonstrate that there were 34.521 treatments in 2014, and total cost of Equilíbrio do Ser was estimated at R$ 1,270,015.70, of that amount, 79,69% were classified as direct costs. The average cost per patient in this period was R$ 34.78, considering individual and collective practices. In conclusion, the service has a high cost per patient when compared to traditional services. This can be considered a risk for implementation and maintenance of the National Policy on Integrative and Complementary Practices in the SUS. Results of costs evaluation need to consider a comprehensive and holistic approach as it is adopted in integrative practices’ field. Studies of cost-effectiveness can contribute to widen and contextualize the health care characteristics in the field of ICPs.
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Roque, Florinda. "Estudo sobre a regulamenta????o cont??bil e a evidencia????o das demonstra????es cont??beis de operadoras privadas de planos de sa??de - modalidade medicina de grupo - no Estado de S??o Paulo, apos a lei n?? 9656/98." FECAP - Faculdade Escola de Com??rcio ??lvares Penteado, 2004. http://132.0.0.61:8080/tede/handle/tede/658.
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Previous issue date: 2004-04-02The Brazilian people can get no satisfaction about the public attendance o healthy sector. It means that the Government politic has been inefficient to maintain a universal healthy system for population. So, the persons who have some better financial conditions, are looking for alternatives on private enterprise to protect themselves, as well as their dependents. Also, the private companies have adopted these strategic fringe benefits to offers to their employees. In Brazil, the healthy plans operators are responsible to attending about thirty five millions of users, considering that this number was bigger in the past. Actually, there are more than hundred operators, which are the following types: Group Medicine, Insurance Company, Self Management and Co-operative of doctors. The insolvency and financial problems of some companies in that sector had as consequence the stop on attendance of users, after contributing for many years. So the society began making pressure to quick the process of regulation on this area, and in 1998 it was approved the law 9656/98, after this it was included many provisory measures and norms, as the creation of a regulatory agency with many regulatory norms. With the sector regulation, it was necessary the juridical orderings of the operator's accounting standards. These juridical orderings brings the obligation of publishing the financial statements and models for this publication. This research analyzed some aspects of the financial statements and the quality of disclosures in the years 2001 and 2002, with intention of reflects if the ways of disclosure presentation helps the users to realize a complete analysis before decide for purchasing healthy plan.
O atendimento insatisfat??rio ?? popula????o na ??rea da sa??de mostra que o Estado ?? ineficiente para manter um sistema universal para atender satisfatoriamente toda a popula????o nessa importante ??rea. Como conseq????ncia, as pessoas de melhor poder aquisitivo buscam na iniciativa privada as alternativas para prote????o da sua sa??de e de seus dependentes. Tamb??m as empresas se valem dessas op????es para oferecer aos seus colaboradores um benef??cio adicional e importante, para a maioria dos trabalhadores, que ?? a assist??ncia m??dica em grupo. No Brasil, as operadoras de planos de sa??de s??o respons??veis pelo atendimento de aproximadamente trinta e cinco milh??es de usu??rios, sendo que este n??mero j?? foi maior. Existem atualmente mais de mil operadoras, classificadas nos tipos Medicina de Grupo, Seguradora, Auto Gest??o e Cooperativa de Trabalho M??dico. A fal??ncia de v??rias empresas deixou muitos usu??rios sem atendimento, mesmo depois de v??rios anos de contribui????o. Tais acontecimentos originaram uma press??o por parte da comunidade de usu??rios, no sentido de agilizar o processo de regulamenta????o dessas atividades, que resultou na aprova????o, em 1998, da Lei n?? 9656/98. Depois disto surgiram outras medidas provis??rias e normas, como a cria????o de uma ag??ncia reguladora, a qual emitiu v??rias normas reguladoras. A regulamenta????o do setor provocou, por sua vez, o ordenamento jur??dico e a normatiza????o dos procedimentos cont??beis das operadoras, os quais, entre outras exig??ncias, determina a obrigatoriedade de publicar as demonstra????es cont??beis, de acordo com os modelos contidos nas normas divulgadas. Esta pesquisa analisou a qualidade das evidencia????es, as pr??ticas cont??beis que as Operadoras de Plano de Sa??de foram obrigadas a seguir de acordo com a Lei n?? 9656/98 e alguns aspectos econ??micos-financeiros, analisados atrav??s do ??ndice de giro operacional das operadoras de plano de sa??de modalidade medicina de grupo no Estado de S??o Paulo, nos anos de 2001 e 2002 no intuito de refletir sobre as exig??ncias de uma sociedade globalizada.
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Severiano, Fabiana Raquel Pires. "Análise exploratória da utilização da contabilidade de gestão no setor da saúde humana." Master's thesis, Instituto Superior de Economia e Gestão, 2019. http://hdl.handle.net/10400.5/20219.
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Mestrado em Contabilidade, Fiscalidade e Finanças EmpresariaisEste estudo pretende identificar os instrumentos de contabilidade de gestão adotados nas empresas de saúde humana em Portugal, bem como o grau de sofisticação, fatores e finalidade da sua adoção. Para esse efeito, recorreu-se às 271 respostas obtidas através do questionário dirigido às empresas da base de dados, cuja análise foi efetuada através do STATA e Qualitative Comparative Analysis. As evidências revelaram que existe uma consciencialização generalizada quanto à importância dos instrumentos de contabilidade de gestão. Ainda assim, quando uma empresa revela que os adota, esta opta por instrumentos menos sofisticados, com o objetivo da gestão de custos. Os resultados sugerem que as empresas públicas de saúde adotam mais instrumentos do que as restantes por serem alvo de regulações ao nível da sua contabilidade de gestão e por sofrerem pressões no sentido da contenção de custos. A adoção de instrumentos por parte das empresas privadas parece ser influenciada pela formação da administração em gestão, sendo que à medida que a sofisticação dos instrumentos aumenta, as empresas adotantes revelam ser também parte integrante de algum grupo empresarial. Desta forma, a adoção de instrumentos mais sofisticados por parte de empresas privadas parece estar associada a empresas com escala, de maneira a poderem diluir custos relacionados com a sua implementação. As empresas não adotantes revelam ser mais antigas, fortemente influenciadas pela tradição e por culturas organizacionais mais rígidas, ou empresas sem escala, por não integrarem grupos económicos ou por insuficiência de dimensão, o que não as permite diluir custos de implementação dos instrumentos.
This study aims to identify the instruments of management accounting adopted by the health care companies in Portugal, as well as the degree of sophistication, factors and purpose of their adoption. Therefore, the 271 obtained answers through an inquiry addressed to the managers of companies from the database were used. Those answers were analyzed through STATA and Qualitative Comparative Analysis. The evidences showed that there is a generalized awareness about the importance of management accounting instruments. Nevertheless, when a company adopts them, it opts for less sophisticated instruments with the objective of cost management. The results suggest that public health care companies use more instruments than private ones, because they are targeted by regulations in what concerns their management accounting and suffer from pressure, cost containment-wise. The adoption of instruments by private companies appears to be influenced by the management training of the administration. As the sophistication of the instruments increases, the adopting companies also reveal to be part of some business group, which allows them to dilute implementation related costs. The non-adopting companies reveal to be older, strongly influenced by tradition and stricter organizational cultures, or companies which are not part of business groups and whose dimensions are not enough to allow them to dilute instruments implementation costs.
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May, Detlef. "Anwendungsfelder der Digitalisierung in der praktischen Landwirtschaft." Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, 2016. http://nbn-resolving.de/urn:nbn:de:bsz:14-qucosa-211625.
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Lopes, Maria Aparecida Soares. "Eficiência dos gastos públicos: análise nas regiões de saúde do estado de Minas Gerais." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/12/12136/tde-01092017-164827/.
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O objetivo geral deste estudo foi analisar a eficiência da execução dos gastos públicos na função saúde em relação aos indicadores de resultados da saúde, nas Regiões de Saúde (RS) mineiras no período de 2010 a 2014. A proposta da análise da evolução dos recursos executados destinados ao financiamento da função saúde, que se transformam em gastos públicos e o que se espera de retorno na forma de resultados finais (outcomes). Verificamos os níveis de eficiência técnica dos gastos públicos na função saúde nas RS de Minas Gerais, em relação ao indicadores de saúde: Taxa de mortalidade infantil e Taxa de mortalidade materna, aplicando a técnica Data Envelopment Analysis (DEA) pelos métodos clássicos de Retornos Constantes de Escala (CCR) e RetornosVariáveis de Escala (BCC), ambos orientado para os outputs, em cada ano do período, de 2010 à 2014. Aplicamos a DEA nas 13 Regiões Ampliadas de Saúde pelo mesmo modelo de BCC com orientação a outputs, e o no modelo CCR para consolidar as DMUs eficientes. As Regiões Ampliadas de Saúde eficientes em todos os anos, foram: Jequitinhonha e Oeste. Enquanto as ineficientes foram as Regiões Nordeste, Noroeste e Norte. Em seguida aplicamos a DEA para as 77 Regiões de Saúde mineiras. Como resultados as fronteiras de eficiência técnica foram compostas por 28 RS no ano de 2010 e por 33 RS em 2011, por 42 RS em 2012. Em 2013, baixou o número para 29 RS eficientes e em 2014, reduziu para 22 RS eficientes. Apresentamos as RS que serviram como referência para o cálculo da eficiência das demais RS. Algumas RS foram eficientes em pelo menos um dos anos, pelo método BCC. As RS com um score de eficiência menor que 100% foram consideradas ineficientes, pois apresentaram escores abaixo da fronteira de eficiência. Calculamos também a eficiência pelo método CRS/CCR, orientado para os outputs com retornos constantes de escala. O CCR por ter retorno de escala constante, validou as RS eficientes por seu rigor na eficiência total do modelo. O CCR apresentou poucas regiões de saúde como eficientes. Em 2010 as RS de Santos Dumont e Varginha; em 2011 a RS de Santos Dumont; em 2012 as RS de Contagem, Minas Novas e Nanuque; em 2013, as RS de Viçosa e Santos Dumont; e em 2014 foram eficientes as RS de Viçosa, Guaxupé e Ituiutaba. Considerando a estimação do nível de eficiência pelo método BCC, na DEA, optamos por observar no detalhe, analisando os indicadores na área da saúde dos municípios que compõem essas Regiões de Saúde que foram ineficientes em todos os anos do período analisado. Assim, verificamos a evolução de 12 indicadores de saúde dos municípios das Regiões de Saúde de Itaobim, Janaúba, Manga, Montes Claros, Salinas, Uberlândia, Araxá e Uberaba. Analisou-se a evolução dos indicadores municipais apresentados, das RS ineficientes em todos os anos analisados, e constatou-se que a maioria dos municípios dessas RS contribuíram para a ineficiência das mesmas. Com base nos resultados de eficiência verificados para cada RS, e a análise dos indicadores municipais nas RS ineficientes, verificou-se o cumprimento das metas pactuadas pelas RS junto aos seus municípios, como o atendimento aos objetivos pactuados. Considerando que, cada município compromete-se com a sua RS, o que entregará de resultado em termos de eficiência. Quanto ao atendimento aos objetivos firmados junto à RS, constatou-se que a maioria dos municípios, com poucas exceções, das RS de Itaobim, Uberlândia, Araxá, Uberaba, Janaúba, Manga, Montes Claros e Salinas não atenderam as metas pactuadas em sua totalidade. Entendemos que os municípios que deixaram de atender as metas pactuadas, descumprindo o contrato firmado, contribuíram com a ineficiência das suas RS. Quanto a obrigatoriedade da entrega do Relatório Anual de Gestão (RAG), constatou-se que a maioria do municípios de todas as RS, com poucas exceções, entregaram o RAG e cumpriram com a suas metas de gestão.The general objective of this study was to analyze the efficiency of the public expenditure execution in the health function in relation to the health outcomes indicators in the Health Regions (RS) of the state of of Minas Gerais in the period from 2010 to 2014. T The proposal of the analysis of the evolution of the resources executed destined to the financing of the health function, which become public expenditures and what is expected to return in the form of outcomes.. We verified the technical efficiency levels of the public expenditures in the health function in the RS of Minas Gerais, in relation to the health indicators: Infant mortality rate and Maternal mortality rate, applying the Data Envelopment Analysis (DEA) technique by the classical methods of Constant Returns (CCR) and Variable Returns Scale (BCC), both oriented to the outputs, in each year of the period, from 2010 to 2014. We applied the DEA in the 13 Expanded Health Regions by the same BCC model with output orientation, and in the CCR model to consolidate efficient DMUs. The Expanded Regions of Health efficient in all the years, were: Jequitinhonha and the Oeste. While the Noroeste, Nordeste and Norte Regions were inefficient. We then applied the DEA to the 77 Health Regions of Minas Gerais. As a result the frontiers of technical efficiency were composed of 28 RS in the year 2010 and 33 RS in 2011, by 42 RS in 2012. In 2013, reduced the number to 29 RS efficient and in 2014, reduced to 22 efficient RS. We present the RS that served as reference for the calculation of the efficiency of the other RS. Some RSs were efficient in at least one of the years by the BCC method. RSs with an efficiency score lower than 100% were considered inefficient, since they presented scores below the efficiency frontier. We also calculate the efficiency by the CRS / CCR method, oriented to the outputs with constant returns of scale. The CCR for having a constant return of scale, validated RS efficient for its rigor in the total efficiency of the model. The CCR presented few health regions as efficient. In 2010 the RS of Santos Dumont and Varginha; In 2011 the RS of Santos Dumont; In 2012 the RS of Contagem, Minas Novas and Nanuque; In 2013, RS de Viçosa and Santos Dumont; and in 2014 the RS of Viçosa, Guaxupé and Ituiutaba were efficient. Considering the estimation of the level of efficiency by the BCC method, the DEA, we opted to observe in detail, analyzing the indicators in the health area of the municipalities that compose these Health Regions that were inefficient in all the years of the analyzed period. Thus, we verified the evolution of 12 health indicators of the municipalities of Itaobim, Janaúba, Manga, Montes Claros, Salinas, Uberlândia, Araxá and Uberaba Health Regions. The evolution of the municipal indicators presented, of the inefficient RSs in all the analyzed years, was analyzed, and it was verified that the majority of the municipalities of these RS contributed to their inefficiency. Based on the efficiency results verified for each RS, and the analysis of the municipal indicators in the inefficient RS, it was verified the achievement of the goals agreed by the RSs with their municipalities, such as meeting the agreed objectives. Considering that each municipality commits itself to its RS, which will deliver results in terms of efficiency. The majority of the municipalities, with few exceptions, from Itaobim, Uberlândia, Araxá, Uberaba, Janaúba, Manga, Montes Claros and Salinas, did not meet the goals agreed in their totality. We understand that the municipalities that failed to meet the agreed targets, not complying with the signed contract, contributed to the inefficiency of their RS. As for the mandatory submission of the Annual Management Report (RAG), it was found that the majority of municipalities in all RSs, with few exceptions, delivered the RAG and complied with its management goals.
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Agyenim-Boateng, Cletus. "Examining the structuration processes in the financial accountability and governance practices pertaining to the public private joint venture partnerships (LIFT) in the UK health sector." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/examining-the-structuration-processes-in-the-financial-accountability-and-governance-practices-pertaining-to-the-public-private-joint-venture-partnerships-lift-in-the-uk-health-sector(96d755d2-22e4-48ac-8324-f4e9c603d8b9).html.
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Shaoul et al. (2012) state that the accounting, scrutiny and oversight of Public Private Partnerships (PPPs) remain areas of concern. Also, there have been calls for a more socio-technical and multidisciplinary approach to accounting and governance studies (Broadbent, 2012; Broadbent and Guthrie 2008), especially in relation to the empirical study of PPPs (Hodge et al., 2010). This thesis responds to these calls in part by drawing on Giddens’ structuration theory to examine the financial accountability and governance concerns that are created in PPP joint venture structures. The empirical work focuses on the health sector, which is identified as one of the sectors inundated by PPP activities, particularly in the UK (Treasury, 2012; Whitfield, 2010). It adopts a case study approach, based on qualitative methodology, which involves documentary analysis of secondary data and interviews in relation to two PPP schemes under the Local Improvement Finance Trust (LIFT) scheme in the UK’s health sector.The thesis investigates: the extent to which the corporate structures of the LIFT scheme do complicate financial accountability and governance including external scrutiny; the extent to which the LIFT scheme does enhance partnership working between the public and private sector partners; the structures in financial accountability and governance in the LIFT scheme; the human agents that provide agency in financial accountability and governance in the LIFT scheme and; whether and in what ways structures and human agency in financial accountability and governance interact in the LIFT scheme and what the implications are.The thesis finds firstly that the complex corporate structure of the LIFT scheme is very complicated and the joint venture mechanism cannot be relied upon to deliver transparency of reporting. Secondly, as limited companies, all financial reporting follows private sector accounting regulations and Company Law and there is minimal disclosure in terms of information available to the general public. This is worsened by lack of information sharing between partners as evidenced in one case study group. Thirdly, there was considerable inconsistency in the reporting due to multiplicity of interpretive schemas between the two case study groups. Fourthly, there was considerable change in the reporting due both to changes in accounting regulations and changes in organisational structure and interpretive schemas throughout the period. Fifthly, there is lack of continuity of public sector oversight and monitoring as the public sector, in practice, restricts its activities to pre-operational phase and limited oversight after construction phases. Moreover, partnership working is very difficult in the context of profit seeking under the LIFT structure. Partnership working and success of the LIFT scheme may depend on trust, key personalities working together as well as leadership. From the structuration perspective, the study finds structural contradictions and conflicts of interests in financial accountability and governance practices. Therefore, transparency, public accountability, oversight and scrutiny are necessarily undermined and, policy makers should pay attention to not only the private sector technologies but also the manner in which they are used to benefit finance capital.
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Blomquist, Tomas, and Johann Packendorff. "Ekonomisk styrning för förändring : en studie av ekonomiska styrinitiativ i hälso- och sjukvården." Doctoral thesis, Umeå universitet, Företagsekonomi, 1998. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-93853.
Full textAbstract:
Since the end of the 1980’s Swedish county council managers has been preoccupied with planning and implementing organisational change in order to alleviate the financial problems and to create more efficient production systems. Many of these efforts to change have implied changing the systems for management accounting and control, changes that have been inspired both by market-oriented ideologies and by the governance principles of large corporations in the private sector. Literature on management accounting and control indicates however, that management is unintentionally contributing to the creation of organisational inertia and conservatism. This contradiction is formulated as a change dilemma; ”How can managerial principles that make organizations subject to bureaucratization and inertia be used as important strategies for organizational change?” The purpose of the study is thus to analyze the use of management control systems as organizational change strategies in health care, employing a change perspective on management control. When used as a change strategy, management accounting and control becomes manifest as management control initiatives. Actors handle these control inititatives by organising themselves around the issue at hand. This organising process ends or fades away when there are no need for further attention to the control initiative. Empirical studies were made in the councils of Västerbotten, Sörmland and Uppsala counties. Management control initiatives investigated were performance-related pay, quality improvement work, systematic planning procedures, provider/purchaser-models, downsizing projects and profit center systems. The systems for management accounting and control appeared to structure health care organisations in terms of spatial structuring temporal structuring and actor categorization. The management control initiatives introduced were structured as extraordinary organising processes delimited in terms of space, time and involved actors. Actors in the administrative norm system participated with the intention to change the organisation, while those in the medical norm system aimed at just handling the initiative. Management control initiatives can therefore be seen as passing opportunities to change, passing in the sense that the organising processes are temporary by nature, opportunities in the sense that temporary re-coupling can be used to achieve long-term change. One such opportunity is the formulation of control initiatives; the possibility of using simple and standardized change strategies can be useful, but only if they are also linked to the medical norm system. A second opportunity is the temporary organising processes; if the project form of organising change can also be conveyed to the medical norm system, management control initiatives could result in short, intense courses of events that actually change things. The third opportunity s the recurrent cyc ica pro perties of management accounting and control systems, enabling recurrent activities around the same themes, thereby keeping them alive.Diss. av båda förf. Umeå : Umeå univ., 1998 ; Framlägges för vinnande av filosofie doktorsexamen respektive ekonomie doktorsexamen.
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