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Accounting Notes Accounting in the New Public Sector Notes

Topic 4 Reading Experts Networks And Inscriptions In The Fabrication Of Accounting Images Notes

Updated Topic 4 Reading Experts Networks And Inscriptions In The Fabrication Of Accounting Images Notes

Accounting in the New Public Sector Notes

Accounting in the New Public Sector

Approximately 80 pages

AC310: Management Accounting, Financial Management and Organizational Control - Module 4 (Accounting in the New Public Sector).

These notes cover the final module of the AC310 Management Accounting course at LSE which covers the following topics: Management accounting and financial management in the 'New Public Sector', including performance measurement, cost accounting, cost management and pricing; the roles of accounting controls in the health system reforms in the UK and elsewhere.

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Introduction

  • Clinicians should be able to make appropriate trade offs

    • But they lack data to make theses decisions

  • PPS (Prospective Payment System) has led to declines in length of stay, imaging rates, number of lab tests, better prevention etc.

    • Clinicians would ask at what patient cost

  • We can never eliminate some degree of judgement but at least we can debate on the basis of evidence and data

  • Quality Assurance is seen as part of administration

Prologue

  • The production of knowledge is as much about power as it is about truth

  • The microcreation of accounting knowledge and its practice is both constituted by and constitutes social and power relations in a post-industrial age characterized by a “mode of information” (Poster, 1990)

About the Story

  • Define “the” output of product of a hospital via its casemix

    • This notion is similar to the manufacturing concept of volume mix

  • Casemix seeks to measure a hospital’s output in a defined period in terms of the number and type of cases (patients) treated

  • A discourse about DRG-based accounting, that is, the allocation of accounting costs to individual DRGs for internal budgetary and managerial control purposes, did not arise until the late 1970s and 1980s (e.g. Fetter el al., 1976)

    • DRG accounting software embodies the Yale Cost Model (YCM)

  • Must appreciate that DRG generation is very different to DRG-based accounting

    • DRG casemixes are statistically generated

  • The Universities projects were:

    • 1) The development of casemix accounting and costing systems using the YCM

    • 2) The development of non-financial casemix management information systems and utilization review

    • 3) The investigation of organizational change, new organizational structures which were appropriate for casemix management and the development of educational packages

The antecedent world of sick governments and hospitals

  • In the 1970s, government agencies came to be perceived as ineffectual and too big and became the subject of extensive reviews

    • E.g. The Bland Inquiry of 1973-1975 in Victoria spoke of major administrative staffing deficiencies, outmoded attitudes and a lack of initiative

  • In 1975, a reformist Labour Commonwealth government created Medibank, a universal health coverage scheme

    • Changed somewhat over the years

    • Still exists today as a universal, state-financed, health coverage modified as the...

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