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管理控制系统与公立医院管理者的临床经验

Management Control Systems and Clinical Experience of Managers in Public Hospitals.

机构信息

Department of Accounting, University Federal of Santa Catarina, Florianópolis-SC 88040-900, Brazil.

Financial Economics and Accounting Department, Pablo de Olavide University, 41013 Sevilla, Spain.

出版信息

Int J Environ Res Public Health. 2018 Apr 17;15(4):776. doi: 10.3390/ijerph15040776.

Abstract

Healthcare authorities are encouraging managers in hospitals to acquire clinical experience and knowledge in order to better carry out and coordinate healthcare service delivery. The main objective of this paper is to analyse how the clinical experience of hospital managers is related to public health institutions’ performance. It is proposed that the effect of the clinical experience on operative and financial organizational performance is indirect through the mediating variables of perceived utility of management information and horizontal management control system. This paper analyses how these variables impact hospital performance through the data from a survey sent to 364 hospital managers in Brazil. The results show that managers’ clinical experience is related to higher perceived utility of historical, financial, short-term, and internal information, but not with horizontal control adoption in hospitals. Furthermore, our results show that, in hospitals, perceived utility of forecasted, non-financial, long-term, and external managerial information positively affects hospitals’ financial performance, while adoption of horizontal control management positively affects operational performance. Through showing evidence that clinical background could explain the differences not only in hospital service management but also in information capabilities and management control processes, this study offer meaningful implications for healthcare authorities and hospital managers involved in the development and implementation of strategies in the health sector.

摘要

医疗保健当局鼓励医院管理人员获得临床经验和知识,以更好地开展和协调医疗保健服务提供。本文的主要目的是分析医院管理人员的临床经验与公共卫生机构绩效的关系。本文提出,临床经验对运营和财务组织绩效的影响是间接的,通过管理信息和横向管理控制系统的感知效用这两个中介变量来实现。本文通过对巴西 364 名医院管理人员进行调查的数据,分析了这些变量如何影响医院绩效。结果表明,管理人员的临床经验与对历史、财务、短期和内部信息的感知效用较高有关,但与医院采用横向控制无关。此外,我们的研究结果表明,在医院中,对预测性、非财务性、长期性和外部管理信息的感知效用正向影响医院的财务绩效,而采用横向控制管理正向影响运营绩效。通过证明临床背景不仅可以解释医院服务管理方面的差异,还可以解释信息能力和管理控制过程方面的差异,本研究为参与制定和实施卫生部门战略的医疗保健当局和医院管理人员提供了有意义的启示。

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