Management Accounting and Control in the Hospital Industry: A Review

This paper presents an overview of the literature in management accounting and control systems (MACS) in the hospital industry. A unique feature of the hospital industry in several countries is not only the coexistence of different ownership forms (such as nonprofit, for-profit, and government), but also diversity within a specific form (such as religious, secular, and university nonprofit hospitals). Organizational objectives and the operating constraints faced by various types of hospitals differ in this “mixed” industry. As a result, one unifying or grand theory is unlikely to provide sufficient insights to understand hospital behavior, especially with respect to MACS design and outcomes. Additionally, the industry has witnessed a variety of regulatory changes, which are primarily aimed at reducing healthcare costs and increasing access. These regulatory changes influence every aspect of MACS. Finally, hospitals face institutional constraints, which have implications for MACS design and use. ...