DRG-based prospective pricing and case-mix accounting-Exploring the mechanisms of successful implementation

Management Accounting Research

Volumn 18, Issue 3, 2007, Pages 367-395

  Lehtonen, Taru ^a  

^a HELSINKI SCHOOL OF ECONOMICS   (Finland)

Author keywords

Case mix accounting systems; DRG based prospective pricing; Management control systems

Indexed keywords

EID: 34447650589     PISSN: 10445005     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.mar.2006.12.002     Document Type: Article

References (100)

1. Abernethy M.A. Physicians and resource management: the role of accounting and non-accounting controls. Finan. Acc. Manage. 12 2 (1996) 142-156
2. Abernethy M.A., and Stoelwinder J.U. The role of professional control in the management of complex organization. Acc. Organ. Soc. 20 1 (1995) 1-17
3. Abernethy M.A., and Stoelwinder J.U. Physicians and resource management in hospitals: an empirical investigation. Finan. Acc. Manage. 6 1 (1990) 17-31
4. Ahrens T., and Dent J.F. Accounting and organizations: realizing the richness of field research. J. Manage. Acc. Res. 10 (1998) 1-39
5. Anthony R.N., and Govindarajan V. Management Control Systems. International Edition 2003. 11th ed (2003), The McGraw-Hill Companies, Inc, New York
6. Association of Finnish Local and Regional Authorities (Suomen Kuntaliitto), 1996. www.norddrg.suomenkuntaliitto.fi, 27.11.1996.
7. Averill R.F. Development. In: Fetter R.B., Brand D.A., and Gamache Dianne D. (Eds). DRGs. Their Design and Development (1991), Health Administration Press, Ann Arbor, Michigan
8. Averill R.F., and Kalison M.J. Structure of a DRG-based Prospective Payment System. In: Fetter R.B., Brand D.A., and Gamache Dianne D. (Eds). DRGs. Their Design and Development (1991), Health Administration Press, Ann Arbor, Michigan
9. Bardsley M., and Coles J. Case mix and management issues. In: Bardsley M., Coles J., and Jenkins L. (Eds). DRGs and Health Care. The Management of Case Mix (1987), King Edward's Hospital Fund for London, London
10. Bartlett W., and Le Grand J. The theory of Quasi-Markets. In: Bartlett W., and Le Grand J. (Eds). Quasi-Markets and Social Policy (1993), The MacMillan Press Ltd, London, UK
11. Bevan G., and Brazier J. Equity and efficiency: clarifying confusion for english acute hospitals. Finan. Acc. Manage. 1 2 (1985) 173-189
12. Bloomfield B.P., and Coombs R. Information technology, control and power: the centralization and decentralization debate revisited. J. Manage. Stud. 29 4 (1992) 459-484
13. Borden J.P. An assessment of the impact of diagnosis-related group (DRG)-based reimbursement on the technical efficiency of New Jersey hospitals using data envelopment analysis. J. Acc. Public Pol. 7 (1988) 77-96
14. Brommels, M., Lahtinen, Y., Linnakko, E., Rytkönen, A., 1988. Suomalainen potilasryhmitysjärjestelmä: DRG-järjestelmän soveltuvuus suomalaisen potilasaineiston luokitteluun. Vaiheen I loppuraportti (The Finnish Patient Grouping System: The feasibility of DRG system for grouping of Finnish patient data. Final report of project phase 1). Yliopistolliset keskussairaalat, Sairaalaliitto, Helsinki.
15. Brunsson N., Lapsley I., and Miller P. Editorial: constructing health care accountants: melding calculation and care. Manage. Acc. Res. 9 (1998) 31-35
16. Charpentier C., and Samuelson L. Effects of new control systems in Swedish health care organizations. Finan. Acc. Manage. 12 2 (1996) 157-171
17. Chua W.-F. Experts, networks and inscriptions in the fabrication of accounting images: a story of the representation of three public hospitals. Acc. Organ. Soc. 20 2/3 (1995) 111-145
18. Chua W.-F., and Degeling P. Interrogating an accounting-based intervention on three axes: instrumental, moral and aesthetic. Acc. Organ. Soc. 18 4 (1993) 291-318
19. Chua W.-F., and Preston A. Worrying about accounting in health care. Acc. Audit Acc. J. 7 3 (1994) 4-17
20. Coombs R.W. Accounting for the control of doctors: management information systems in hospitals. Acc. Organ. Soc. 12 4 (1987) 389-404
21. Coulam R.F., and Gaumer G.L. Medicare's prospective payment system: a critical appraisal. Health Care Finan. Rev. 13 2 (annual supplement) (1991) 45
22. Covaleski M.A., Dirsmith M.W., and Michelman J.E. An institutional theory perspective on the DRG framework, case-mix accounting systems and health-care organisations. Acc. Organ. Soc. 18 1 (1993) 65-80
23. Covaleski M.A., and Dirsmith M.W. Budgeting as a means of control and loose coupling. Acc. Organ. Soc. 8 4 (1983) 323-340
24. DiMaggio P.J., and Powell W.W. The Iron Cage Revisited: Institutional Isomorphism and Collective Rationality in Organizational Fields. In: Powell W.W., and DiMaggio P.J. (Eds). The New Institutionalism in Organizational Analysis (1991), The University of Chicago Press, Chicago
25. Donaldson C., and Magnussen J. DRGs: the road to hospital efficiency. Health Pol. 21 1 (1992) 47-64
26. Doolin B. Casemix management in a New Zealand hospital: rationalisation and resistance. Finan. Acc. Manage. 14 3-4 (1999) 397-417
27. Enthoven A.C., and Noll R.G. Prospective payment: will it solve medicare's financial problem?. Issues Sci. Technol. 1 1 (1984) 101-116
28. Fetter R.B. Hospital payment based on diagnosis-related groups. J. Soc. Health Syst. 3 4 (1992) 4-15
29. Fetter R.B. Background. In: Fetter R.B., Brand D.A., and Gamache Dianne D. (Eds). DRGs. Their Design and Development (1991), Health Administration Press, Ann Arbor, Michigan
30. Fetter R.B. Introduction. In: Bardsley M., Coles J., and Jenkins L. (Eds). DRGs and Health Care. The Management of Case Mix (1987), King Edward's Hospital Fund for London, London
31. Fetter R.B., and Freeman J.L. Diagnosis related groups: product line management within hospitals. Acad. Manage. Rev. 11 1 (1986) 55-70
32. Fligstein N. The Structural Transformation of American Industry: An Institutional Account of the Causes of Diversification in the Largest Firms, 1919-1979. In: Powell W.W., and DiMaggio P.J. (Eds). The New Institutionalism in Organizational Analysis (1991), The University of Chicago Press, Chicago
33. Government Institute for Economic Research, 1995. Terveydenhuollon palvelut-kilpailua ja valinnanvapautta. Palvelujen tutkimus- ja kehittämishankkeen terveys- ja sairaanhoitopalvelujen työryhmän loppuraportti. VATT-keskustelualoitteita 86. Valtion taloudellinen tutkimuskeskus (Government Institute for Economic Research), Helsinki.
34. Guterman S., Eggers P.W., Riley G., Greene T.F., and Terrell S.A. Experience with a DRG based prospective payment system. In: Fetter R.B., Brand D.A., and Gamache Dianne D. (Eds). DRGs. Their Design and Development (1991), Health Administration Press, Ann Arbor, Michigan
35. Hopwood A.G. Accounting and the pursuit of efficiency. In: Hopwood A.G., and Tomkins C. (Eds). Issues in Public Sector Accounting (1984), Philip Allen, Oxford
36. Hood C. The "New Public Management" in the 1980s: variations on a theme. Acc. Organ. Soc. 20 2/3 (1995) 93-109
37. Häkkinen U. The changing roles of municipalities in Finnish health care. Eurohealth 4 1 (1997) 18-20
38. Häkkinen U. Health care in Finland: current issues. In: Alban A., and Christiansen T. (Eds). The Nordic Lights. New Initiatives in Health Care Systems (1995), Odense University Press, Odense
39. Ittner C.D., and Larcker D.F. Assessing empirical research in managerial accounting: a value-based management perspective. J. Acc. Econ. 32 (2001) 349-410
40. Jacobs K., Marcon G., and Witt D. Cost and performance information for doctors: an internal comparison. Manage. Acc. Res. 15 (2004) 337-354
41. Jones C.S. Developing financial accountability in British acute hospitals. Finan. Acc. Manage. 15 1 (1999) 1-20
42. Jones C.S., and Dewing I.P. The attitudes of NHS clinicians and medical managers towards changes in accounting controls. Finan. Acc. Manage. 13 3 (1997) 261-279
43. Keating P.J. A framework for classifying and evaluating the theoretical contributions of case research in management accounting. J. Manage. Acc. Res. Fall (1995) 66-86
44. Kekomäki M. The Finnish health care system. In: von Eiff W. (Ed). International Hospital Comparison. International Health Care Systems in Comparison vol. 1 (2000), Bertelsmann Foundation Publishers, Gütersloh
45. Kekomäki M. Muuttuva sairaala. Kanava 7 (1997) 356-360
46. Konttinen, M., Rytkönen, A., Seppälä, A., Tolppanen, E.-M., Heliö, R., 1989. Tulosmittaaminen ja sen kehittäminen Helsingin yliopistollisessa keskussairaalassa. Tulosmittariprojektin loppuraportti 31.12.1988. Tutkimusjulkaisuja 1/1989. Helsingin yliopistollinen keskussairaala, Helsinki.
47. Kurunmäki L. A hybrid profession-the acquisition of management accounting expertise by medical professionals. Acc. Organ. Soc. 29 (2004) 327-347
48. Kurunmäki L. Professional vs. financial capital in the field of health care-struggles for the redistribution of power and control. Acc. Organ. Soc. 24 (1999) 95-124
49. Kurunmäki L., Lapsley I., and Melia K. Accountingization v. legitimation: a comparative study of the use of accounting information in intensive care. Manage. Acc. Res. 14 (2003) 112-139
50. Lapsley I. The accounting-clinical interface-implementing budgets for hospital doctors. Abacus 37 1 (2001) 79-109
51. Lapsley I. Accounting and the new public management: instruments of substantive efficiency or a rationalising modernity?. Finan. Acc. Manage. 15 3-4 (1999) 201-207
52. Lapsley I. Market mechanism and the management of health care. The UK model and experience. Int. J. Public Sector Manage. 7 6 (1994) 15-25
53. Lapsley I. Responsibility accounting revived? Market reforms and budgetary control in health care. Manage. Acc. Res. 5 (1994) 337-352
54. Lapsley I., and Wright E. The diffusion of management accounting innovations in the public sector: a research agenda. Manage. Acc. Res. 15 (2004) 355-374
55. Lauharanta, J., 1998. HYKSin uusi NordDRG-hinnoittelu ja kuntalaskutus. In: Nenonen, M. (Eds.). DRG (Diagnosis Related Groups) Suomalaisessa Terveydenhuollossa 1998. STAKES Tilastoraportti 1/1998, Helsinki.
56. Laughlin R., Broadbent J., Shearn D., and Willig-Atherton H. Recent financial and administrative changes in GP practices in the UK: initial experiences and effects. Acc. Audit. Acc. J. 7 (1994) 92-124
57. Lauharanta J., Virtanen M., Rotonen M., Tierala I., Kyllönen L., and Kekomäki M. NordDRG-erikoissairaanhoidon tuleva pohjoismainen tuotteistusstandardi?. Suomen Lääkärilehti 52 35 (1997) 4210-4217
58. Lehtonen, T., 2001. In Search of Efficiency-NordDRG Based Pricing and Case-Mix Accounting. HSEBA Working Paper, Helsinki.
59. Linna M. Benchmarking in Finnish Hospitals-Towards More Efficient Care (2000), National Research and Development Centre for Welfare and Health, Helsinki
60. Linnakko E., and Back J. From planning to market allocation in Finnish health care. In: Alban A., and Christiansen T. (Eds). The Nordic Lights. New Initiatives in Health Care Systems (1995), Odense University Press, Odense
61. Llewellyn S., and Northcott D. The average hospital. Acc. Organ. Soc. 30 6 (2005) 555-583
62. Lowe A. Accounting in health care: some evidence on the impact of casemix systems. Br. Acc. Rev. 32 (2000) 189-211
63. Lowe A., and Doolin B. Casemix accounting systems: new spaces for action. Manage. Acc. Res. 10 3 (1999) 181-201
64. Markus M.L., and Pfeffer J. Power and the design and implementation of accounting and control systems. Acc. Organ. Soc. 8 2/3 (1983) 205-218
65. Meklin P., and Näsi S. Budjettiohjauksen uudistus ja laskentatoimen muuttuva rooli julkisessa hallinnossa (economic directing and accounting in the new public management). Hallinnon Tutkimus 4 (1994) 231-243
66. Merchant K.A., and Van der Stede W.A. Management Control Systems. Performance Measurement, Evaluation and Incentives (2003), Pearson Education Limited, Essex, UK
67. Meyer J.W., and Rowan B. Institutionalized organizations: formal structure as myth and ceremony. In: Powell W.W., and DiMaggio P.J. (Eds). The New Institutionalism in Organizational Analysis (1991), The University of Chicago Press, Chicago
68. Mikkola H., Keskimäki I., and Häkkinen U. DRG-related prices applied in a public health care system-can Finland learn from Norway and Sweden?. Health Policy 59 (2001) 37-51
69. Ministry of Finance, 1992. Julkisen sektorin uudistaminen. Hallituksen päätös julkisen sektorin uudistamiseksi. Valtiovarainministeriö (Ministry of Finance), Helsinki.
70. Ministry of Social Affairs and Health, 1998. Pääkaupunkiseudun ja Uudenmaan erikoissairaanhoidon toiminnan ja hallinnon uudistamistyöryhmän (PUERTO) muistio. Työryhmämuistioita 1998:14. Sosiaali- ja terveysministeriö (Ministry of Social Affairs and Health), Helsinki.
71. Ministry of Social Affairs and Health, 1997. Health Care in Finland, fourth ed. Brochures 2/1997. Ministry of Social Affairs and Health, Helsinki.
72. Ministry of Social Affairs and Health, 1992. Terveydenhuollon kuntakorvausprojektin muistio. Työryhmämuistio 1992:19. Sosiaali- ja terveysministeriö (Ministry of Social Affairs and Health), Helsinki.
73. Ministry of Social Affairs and Health, 1991. Terveydenhuollon kuntakorvaustyöryhmän muistio. Työryhmämuistio 1991:25. Sosiaali- ja terveysministeriö (Ministry of Social Affairs and Health), Helsinki.
74. Otley D. Extending the boundaries of management accounting research: developing systems for performance management. Br. Acc. Rev. 33 (2001) 243-261
75. Otley D.T. Performance management: a framework for management control systems research. Manage. Acc. Res. 10 4 (1999) 363-382
76. Otley D.T. The contingency theory of management accounting: achievement and prognosis. Acc. Organ. Soc. 5 4 (1980) 413-428
77. Otley D.T., and Berry A.J. Case study research in management accounting and control. Manage. Acc. Res. 5 (1994) 45-65
78. Paavilainen H. Voiko terveydenhuolto olla edullista?. Suomen lääkärilehti 54 9 (1999) 1105
79. Palmer G.R., Freeman J.L., and Rodrigues J.-M. Development and application of DRGs in other countries. In: Fetter R.B., Brand D.A., and Gamache Dianne D. (Eds). DRGs. Their Design and Development (1991), Health Administration Press, Ann Arbor, Michigan
80. Pekurinen, M., Vohlonen, I., 1991. Terveydenhuollon uudistukset: Miksi, mitä ja mihin 1990-luvulla? (Reforms in the Finnish Health Care: Why, what and whither in the 1990s?). Kuopion yliopiston julkaisuja. Yhteiskuntatieteet, alkuperäistutkimukset 2/91, Kuopio.
81. Pettersen I.J. Hesitation and rapid action: the new public management reforms in the Norwegian hospital sector. Scan. J. Manage. 17 (2001) 19-39
82. Pettersen I.J. Accountable management reforms: why the Norwegian hospital reform experiment got lost in the implementation. Finan. Acc. Manage. 15 3-4 (1999) 377-396
83. Pettersen I.J. Budgetary control of hospitals-ritual rhetorics and rationalized myths?. Finan. Acc. Manage. 11 3 (1995) 207-221
84. Pollitt C. The changing context. In: Pollitt C., Giree X., Lonsdale J., Mul R., Summa H., and Waerness M. (Eds). Performance or compliance? Performance audit and public management in five countries (1999), Oxford University Press, New York
85. Preston A.M. The birth of clinical accounting: a study of the emergence and transformation of discourses on costs and practices of accounting in US hospitals. Acc. Organ. Soc. 17 1 (1992) 63-100
86. Preston A.M., Chua W.-F., and Neu D. The diagnosis-related-group-prospective payment system and the problem of the government of rationing health care to the elderly. Acc. Organ. Soc. 22 2 (1997) 147-164
87. Preston A.M., Cooper D.J., and Coombs R. Fabricating budgets: a study of the production of management budgeting in the National Health Service. Acc. Organ. Soc. 17 6 (1992) 561-593
88. Rogers E.M. Diffusion of Innovations. fourth ed. (1995), The Free Press, New York
89. Ryan B., Scapens R.W., and Theobald M. Research Method and Methodology in Finance and Accounting (1992), Academic Press Limited, London
90. Saltman R.B. National planning for locally controlled health systems: the Finnish experience. J. Health Politics Pol. Law (1988) 27-51
91. Sanderson H. DRGs in the NHS. In: Bardsley M., Coles J., and Jenkins L. (Eds). DRGs and Health Care. The Management of Case Mix (1987), King Edward's Hospital Fund for London, London
92. Scott W.R., Ruef M., Mendel P.J., and Caronna C.A. Institutional Change and Healthcare Organizations. From Professional Dominance to Managed Care (2000), The University of Chicago Press, Chicago
93. Sumner A.T., and Moreland C.C. The potential impact of diagnosis related group medical management on hospital utilization and profitability. Health Care Manage. Rev. 20 2 (1995) 92-100
94. Weiner S.L., Maxwell J.H., Sapolsky H.M., Dunn D.L., and Hsiao W.C. Economic incentives and organizational realities: managing hospitals under DRGs. Milbank Quart. 65 4 (1987) 463-487
95. Act on Helsinki University Central Hospital, 1064/1989 (in Finnish). Laki Helsingin yliopistollisesta keskussairaalasta, 1064/1989.
96. HUCH's NordDRG project group, 1997. Final report of the HUCH's NordDRG project group 13.8.1997 (in Finnish). HYKSin tuotteistusta valmistelevan projektiryhmän loppuraportti 13.8.1997. Helsingin yliopistollinen keskussairaala.
97. HUCH's product definition project group, 1994. Final report of HUCH's product definition project group 3.6.1994 (in Finnish). Tuotteistus-projektin loppuraportti 3.6.1994. Helsingin yliopistollinen keskussairaala.
98. HUCH's annual report 1997, 1998, 1999 (in Finnish). HYKS vuosikertomus, 1997, 1998, 1999.
99. HUCH's IT strategy proposal (in Finnish). HYKSin tietohallintostrategia. Tietojenkäsittelyn ohjausryhmän ehdotus 16.9.1996.
100. Regional Planning Committee, 1996. Proposal for the product definitions of specialized health care for 1997 in Uusimaa region (in Finnish). Ehdotus Uudenmaan erikoissairaanhoidon hoitopalvelujen tuotteistukseksi 1997. Yhteenveto Kyhmy-työryhmän sekä avohoidon, lastentautien ja psykiatrian tuotteistustyöryhmien ehdotuksista. HYKS toimikunta 15.2.1996.