19,264 research outputs found

    China’s healthcare costing in times of crisis: conflicts, interactions and hidden agendas

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    This paper presents a longitudinal interpretive case study on the development of healthcare costing in China over the period 2002 to 2015. Adopting a middle-range theory lens, the study explores dynamic interactions in the use of cost information among societal institutions and organizations. It reports the successful internalization of costing systems in public hospitals in Beijing, which supports the effectiveness of a hybrid steering mechanism combining both transactional and relational features; however, such successful internalization does not indicate the success of steering the lifeworld of institutions and organizations towards change. Notably, hospitals’ responses to steering alter over time, from passive absorption to active manipulation, revealing how cost information may underpin hospital beliefs in marketization. At an institutional level, the paper provides empirical evidence for relational steering among societal institutions, where a reaction of ‘rebuttal’ is observed. It offers insights on how accounting can be a powerful tool in legitimizing such rebuttal, while keeping political considerations as hidden agendas. The findings suggest the importance of understanding lifeworld complexity at both societal and organizational levels, and cross-institutional collaboration in using accounting as a steering mechanism. The findings have important policy implications for public sector reform, both in China and worldwide

    The evolution of management control combination in the transformation toward hybridity: a case study

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    This paper investigates how management control (MC) practices evolve in nature and interrelationship as control problems develop in a dynamic environment. Drawing on coupling theory, it examines how three MC practices – cultural control, budgeting control, and performance measurement – are (re)coupled across two distinct periods in a Chinese state-owned company. During the organisational transition from a government-oriented model to a more complex hybrid-business model, the findings indicate that control problems increase in both scope and complexity. Correspondingly, the combination of MC practices shifts from more informal culture control loosely coupled with budgeting, towards a more rigid and comprehensive budgeting and performance measurement system, supported by more formal culture control in a tightly coupled combination. The study illustrates how MC combinations evolve from loose to tight coupling through simultaneous adjustments in individual practices themselves and in their responsiveness and distinctiveness when combined. This suggests that flexibility in control may lie in an organisation’s capability to adapt – by revitalising existing MC practices, introducing new ones, and reshaping their combinations – rather than in the fixed nature of any single practice or type of coupling. The findings contribute to the literature on MC combination in general, and on MC in hybrid organisations in particular, while offering important practical insights into enhancing the effectiveness of MC in organisations
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