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Reforming the reform: changing roles for accounting and management in the Italian health care sector

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  • Giuseppe Marcon
  • Fabrizio Panozzo

Abstract

This paper examines the ways in which accounting has intervened in the process of reforming the original 'reform' of the Italian health care system. By stepping into an ongoing process accounting has been asked not only to foster efficiency, effectiveness and value for money, but to correct as well the 'degeneration' of the original reform, which subjected health care delivery to 'democratic' scrutiny and political control. The call for a greater accountability in the use of public resources has been thus interpreted as both a mechanism of surveillance and control and a way to resist the 'over-politicization' of health sector management together with the abuses, scandals and fraudulent behaviour it induced. In seeking to interpret the specificity of the Italian experience, the paper suggests that the range of 'the contexts in which accounting operates' should be broadened in order to gain a deeper understanding of its roles in those institutions, such as health care systems, which play a crucial role in modern societies. In order to move in this direction systematic and empirically grounded cross-national comparisons are called for, since, although accounting and management are involved in virtually all attempts to redesign health care services, consequences are likely to be different when conditions of possibility differ at the outset.

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  • Giuseppe Marcon & Fabrizio Panozzo, 1998. "Reforming the reform: changing roles for accounting and management in the Italian health care sector," European Accounting Review, Taylor & Francis Journals, vol. 7(2), pages 185-208.
    • Handle: RePEc:taf:euract:v:7:y:1998:i:2:p:185-208
    DOI: 10.1080/096381898336448
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    2. Mario Nicoliello & Dennis Tracchia, 2014. "La misurazione della performance nel settore pubblico: il caso del trasporto pubblico locale," MANAGEMENT CONTROL, FrancoAngeli Editore, vol. 2014(1), pages 35-53.
    3. Campanale, Cristina & Cinquini, Lino, 2016. "Emerging pathways of colonization in healthcare from participative approaches to management accounting," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 39(C), pages 59-74.
    4. Sara Bonini Baraldi & Paolo Ferri, 2019. "From communism to market: business models and governance in heritage conservation in Poland," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 23(3), pages 787-812, September.
    5. Le Theule, Marie-Astrid & Lambert, Caroline & Morales, Jérémy, 2023. "Accounting to the end of life. Scarcity, performance and death," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 90(C).
    6. Kraus, Kalle & Kennergren, Cecilia & von Unge, Amelie, 2017. "The interplay between ideological control and formal management control systems – A case study of a non-governmental organisation," Accounting, Organizations and Society, Elsevier, vol. 63(C), pages 42-59.
    7. Antonio Barretta, 2005. "The difficulties presented by cost comparison for health care trusts," Public Management Review, Taylor & Francis Journals, vol. 7(4), pages 589-613, December.
    8. Bertrand Malsch & Marie-Soleil Tremblay & Jeffrey Cohen, 2022. "Non-audit Engagements and the Creation of Public Value: Consequences for the Public Interest," Journal of Business Ethics, Springer, vol. 178(2), pages 467-479, June.
    9. Martinussen, Pål Erling & Magnussen, Jon, 2011. "Resisting market-inspired reform in healthcare: The role of professional subcultures in medicine," Social Science & Medicine, Elsevier, vol. 73(2), pages 193-200, July.
    10. Eriksen, Scott D. & Urrutia, Ignacio, 2005. "An institutional sociology perspective of the implementation of activity based costing by Spanish health care institutions," IESE Research Papers D/582, IESE Business School.
    11. Malcolm Anderson, 1999. "Accounting History Publications 1998," Accounting History Review, Taylor & Francis Journals, vol. 9(3), pages 375-384.
    12. Cristina Campanale & Lino Cinquini & Andrea Tenucci, 2014. "Il Time-Driven Activity-Based Costing per la gestione dei costi in logica di spending review: riflessioni da un caso di azienda ospedaliera," MECOSAN, FrancoAngeli Editore, vol. 2014(91), pages 9-42.
    13. Elisa Bonollo, 2015. "Disclosures in Local Healthcare Organizations? Social Reports. ?What?? and ?Why?? An Empirical Analysis of the Italian National Healthcare System," FINANCIAL REPORTING, FrancoAngeli Editore, vol. 2015(1), pages 41-75.
    14. Caterina Cavicchi & Chiara Oppi & Emidia Vagnoni, 2019. "On the feasibility of integrated reporting in healthcare: a context analysis starting from a management commentary," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 23(2), pages 345-371, June.

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