论预算管理体系的改进

预算管理是企业内部控制系统的重要构成部分,但现实中的预算管理体系存在着许多不足之处.本文指出预算管理的功能应当是进行资源配置与信息沟通、预算目标应当与企业战略规划互动并且是现实的、预算管理流程应当主要包括预算的形成、预算调控与修订、预算报告等方面的内容.     

THE IMPACT OF POLITICAL INTERESTS UPON THE FORMULATION OF PERFORMANCE MEASUREMENTS: THE NHS STAR RATING SYSTEM

This study examines the impact of political interests of the Blair Government on the development of the NHS star rating system. It argues that the use of performance measurements (PMs) is not detached from its political context but influenced by institutional interests including in particular those of the Government. The analysis indicates that the formulation of the specifics of PM, and of performance information within the NHS star rating system, was skewed to reflect the political objectives of the Blair Government. PMs are not merely neutral instruments, but, suffused with institutional interests, serve as a coercive mechanism to impose pressures upon the NHS as well as seeking to create a public perception of performance improvement. This study concludes that PMs in the public sector are influenced by the need to serve the political interests of the Government.     

预算功能彰显及其绩效研究——基于我国企业预算管理调查问卷的实证检验

本文在提炼与描述了预算的四项功能(业务规划、业绩评价、目标沟通、战略形成)的基础上,研究了各项预算功能彰显程度的环境决定因素、预算功能与预算特征的关系,以及各项预算功能是如何影响组织绩效的。研究发现,预算功能具有多重性,预算环境是各种预算功能彰显的重要驱动因素,各项预算功能都伴随着相应的预算特征,并对组织绩效产生不同影响。     

中国公共预算改革的目标选择:近期目标与远期目标*

本文运用凯顿的预算模式理论研究了中国公共预算改革的目标选择主要结论是,中国现阶段仍然应该以建立一种\"控制取向\"的现代公共预算体制为目标,中国预算改革的当务之急是将政治控制与行政控制纳入预算过程.最后,虽然新绩效预算是一种非常理想的预算模式,但是,中国目前并不具备实行的条件.即使对于实行新绩效预算来说,先实行一种\"控制取向\"的预算体制也是有帮助的.     

Loose coupling in asset management systems in the NHS

This paper aims to identify whether the components of a loose-coupled system were present in the asset management systems of the National Health Service (NHS) in Wales and, if so, whether this had a negative impact. By utilising a qualitative analysis of semi-structured interviews with senior officials at two NHS Hospital Trusts together with the findings of a survey of all of the Hospital Trusts in Wales, we conclude that the asset management system of the NHS in Wales exhibits the features of a loosely coupled system with detrimental consequences. Where information on capital assets has been required below board level, lower management relies on local systems, while the information for senior managers and political leaders relies on the management accounting system and ad hoc enquiries. The result has been an impairment of the ability of lower management to reconfigure capital assets which leads to the nation's health service underperforming.     

Budgeting—the Role of Trust and Participation: A Research Note

Prior studies have found a combination of an evaluative style with high budget emphasis and high participation to be associated with better behavioural outcomes (e.g., lower job-related tension) than all other combinations of budget emphasis and participation. Yet there has been little research to investigate the theory on why this particular combination of budget emphasis and participation is associated with better behavioural outcomes. A path analytical model, which investigates the intervening effects of trust and participation on the relationship between budget emphasis and job-related tension, was used. Senior Norwegian managers were selected as subjects for this study. The results indicate that budget emphasis has an insignificant direct effect on job-related tension but a strong indirect effect through trust and participation. Trust also has an intervening effect on the relationship between budgetary participation and job-related tension. It is therefore possible to conclude that high budget emphasis is associated with high budgetary participation and high trust. High trust, in turn, is associated with reduced subordinates' job-related tension.     

Using contractual incentives in district nursing in the English NHS: results from a qualitative study

Since 2008, health policy in England has been focusing increasingly on improving quality in healthcare services. To ensure quality improvements in community nursing, providers are required to meet several quality targets, including an incentive scheme known as Commissioning for Quality and Innovation (CQUIN). This paper reports on a study of how financial incentives are used in district nursing, an area of care which is particularly difficult to measure and monitor.     

THE SEARCH FOR A PROPORTIONATE CARE LAW BY FORMULA FUNDING IN THE ENGLISH NHS

Although the National Health Service was created to achieve equity of access to health care in 1948, over twenty years later an 'inverse care law' was seen to operate. The 1976  Report of the Resource Allocation Working Party  laid the principles of formula funding to achieve an equitable distribution of resources, to move, over time, towards the operation of a proportionate care law. These principles have been applied ever since in England. This paper describes the context, governance and subsequent development of formulas and three persistent problems: accounting for populations, their needs and variations in the unavoidable costs of providers. The paper concludes by outlining continuing problems from the past and new challenges of formula funding in England to reduce 'avoidable' inequalities in health.     

Performance management: a framework for management control systems research

This paper proposes a framework for analysing the operation of management control systems structured around five central issues. These issues relate to objectives, strategies and plans for their attainment, target-setting, incentive and reward structures and information feedback loops. Their central focus is on the management of organizational performance. Because the framework has been inductively developed, its application is `tested' against three major systems of organizational control, namely budgeting, economic value added and the balanced scorecard. In each case, neglected areas of development are exposed and fruitful topics for research identified. It is believed that the framework can usefully be developed further by its use in analysing other instances of management control systems practice, and that case-based, longitudinal studies provide the best route to this end.     

A LONGITUDINAL STUDY OF CHANGE IN THE ENGLISH NATIONAL HEALTH SERVICE

This paper reports the findings of a longitudinal comparative case study of three National Health Service (NHS) hospital Trusts in England, investigating the perceptions of clinical, managerial and accounting professionals towards changing cost accounting and performance measurement practices. It incorporates both qualitative and quantitative data analysis, and is based on a contextualist understanding of change management, utilising the content‐process‐context approach (Pettigrew and Lapsley, 1994) to investigate the influence of receptive versus non‐receptive contexts on change. The analysis reveals limited success in improving performance measurement practices (the content of change) in Trusts. Nevertheless the specific context within which change was operationalised was found to be very important, with central mangers playing a key role in influencing change. The process of change indicated slow shifts in clinical‐accountant‐managerial relations, partly driven by changes in financial flows within the organisations.     

Delivering patient choice in English acute hospital trusts

The role of the patient within the NHS has changed from supplicant to consumer to active participant. A demand-side patient-led approach is combining quasi-consumerism and participative democracy to inform and facilitate patient choice. On the supply-side funding and incentives coupled to reform and performance will deliver additional hospital capacity and patient choice. This paper argues from both a demand and supply-side perspective that there is a large gap between the rhetoric and reality of delivering patient choice in acute hospitals.     

ASSESSING CAPITAL CHARGING IN THE NATIONAL HEALTH SERVICE

Capital charging was introduced into the NHS in 1991, as one of the components of the internal market reforms. Having established context and rationale, this article reviews published surveys of capital charging. It then reports the results of a questionnaire survey conducted in 1994 which probed the views of finance and estates staff in NHS provider units in Scotland as to the efficacy and effects ofcapital charging. Strong support for the principle of capital charging was found, despite considerable evidence of implementation difficulties which had differentially impacted upon Health Boards. Respondents expected that the effects of capital charging would be lower investment and higher disposals, thus leading to a smaller NHS estate.     

Expenditure on healthcare in the UK: A review of the issues

This review examines the performance of the UK healthcare system. After presenting data on the level and distribution of resources, three topics are examined. The first is the lessons from international comparisons of evidence on expenditure, equity and healthcare outcomes. The second is the lessons from the recent internal market reforms. The third is the lessons from an analysis of the role for private finance in UK healthcare. The review concludes that economists and policymakers need to focus more attention on the relationship between healthcare inputs — expenditure — and health outcomes, and, within this, on the incentives facing suppliers and demanders of healthcare.