Management Accounting and Coordination by Middle Management’s Coordination in Health Care Organizations

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  • 医療機関における管理会計システムとミドルマネジメントの調整
  • 医療機関における管理会計システムとミドルマネジメントの調整 : ミドルマネジメントの組織内調整に関する文献レビュー
  • イリョウ キカン ニ オケル カンリ カイケイ システム ト ミドルマネジメント ノ チョウセイ : ミドルマネジメント ノ ソシキ ナイ チョウセイ ニ カンスル ブンケン レビュー
  • ミドルマネジメントの組織内調整に関する文献レビュー
  • A Literature Review

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Abstract

The purpose of this review paper is to show how middle management in healthcare organizations coordinates their organizations utilizing management accounting system (s) between top management and frontline healthcare professionals. Management accounting system (s) was endeavored to introduce into a healthcare organizations due to introducing New Public Management (NPM) initiatives. However, prior research indicates, as a result of introduction of management accounting system (s), frontline medical professionals react in two different ways-resistance and acceptance. This paper focuses on a role of middle managements’ coordination in order to secure goal-congruence. There are two roles of middle management in a healthcare organization, which are “Absorption” and “Two-way windows.” The former role means that middle management considers a function of a frontline operation as the first priority and absorbs accounting information from top management so that the information does not influence frontline activities. The latter role means that middle management translate accounting information from top management into bottoms to both concrete a frontline activity and communicates the information to frontline staffs, to collect opinions from frontline staff opinions and is reflected to top management. As a result of literature review, this paper clarifies two findings. First, while middle management is required multiple accountability such as “professionals” and “managers”, they decide their role out of two ways-“Absorption” or “Two-way windows”, and control role expectations of top management and frontline staffs, in accordance with their organizational contexts. Second, this paper indicates that it is unclear how and why middle management keep their Absorption role utilizing management accounting system (s) and absorb collected information from frontline, without informing it to top management. This paper indicates the unclear point as a future research issue. This paper has important contribution to show an unclear point of organization coordination by middle management and reveal the future research issue.

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