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Tight budgetary control: a study of clinical department managers' perceptions in Swedish hospitals
Lund University, Sweden.ORCID iD: 0000-0001-7826-1110
2009 (English)In: Journal of Health Services Research and Policy, ISSN 1355-8196, Vol. 14, no 2, 70-76 p.Article in journal (Refereed) Published
Abstract [en]

Objective The composition of clinical department managers in Swedish hospitals is changing; more non-doctors and women are entering managerial positions. In parallel, most hospitals face increased pressure to contain costs. This article presents a study of managers' perceptions of tightness of budgetary control and how their views vary systematically with personal characteristics and organizational conditions.

Method Data were collected through a postal survey in 2005 to 173 clinical department managers (response rate of 70%). Statistical analysis was performed by factor analysis and logistic regression.

Results The data suggest that clinical department managers' perceptions of tight budgetary control were related to how long they had been in their current position, their profession (whether they were doctors or non-doctors) and their sex. Further, their perceptions could be explained by how close the managers' departments were to their budget targets.

Conclusions Perception of tight budgetary control by managers depends on both their personal characteristics and the financial situation of their departments. Differences between men and women, and doctors and non-doctors call for additional research about the possible impact of changes in the composition of clinical department managers on how budgetary responsibility is exercised.

Place, publisher, year, edition, pages
Sage Publications, 2009. Vol. 14, no 2, 70-76 p.
National Category
Business Administration
Research subject
Economy, Business administration
Identifiers
URN: urn:nbn:se:lnu:diva-41054DOI: 10.1258/jhsrp.2008.008063OAI: oai:DiVA.org:lnu-41054DiVA: diva2:796912
Available from: 2015-03-20 Created: 2015-03-20 Last updated: 2015-03-31Bibliographically approved
In thesis
1. Budgetary control in public health care: a study about perceptions of budgetary control among clinical directors
Open this publication in new window or tab >>Budgetary control in public health care: a study about perceptions of budgetary control among clinical directors
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Health care expenditures have increased rapidly in most OECD-countries, and several reforms have been considered for the improvement of cost-containment in the health care sector. Physicians in particular have been recognized to have considerable impact on health care expenditures and as a result they have become increasingly involved in budgetary control with the hope of a more efficient use of resources. Until 1997 only physicians were allowed to take clinical directional positions in Sweden. Then a new regulation made it possible for non-physicians to become clinical directors of a hospital department or primary care centre. Most often it has been nurses who entered such positions in the Swedish health care. The overall aim of this thesis was to analyse perceptions of tight budgetary control among clinical directors with different professional backgrounds in public health care organizations. Three questionnaire surveys of clinical directors in both hospitals and primary health care have been conducted. The results suggest that the perception of budgetary control differs between groups of clinical directors. The nurses often perceived the budgetary control as tighter than the physicians. The findings adhere to previous theories that nurses in directorial positions adopt administrative principles more easily; they accept and feel more bound by budgetary control than physicians in the same position. An alternative interpretation is that nurses in these positions actually are more controlled by the hospital management than the physicians. The nursing profession has a lower status and nurses in directorial positions may have less autonomy for managing their department.

Place, publisher, year, edition, pages
Lund: Lund Business Press, 2012. 78 p.
Series
Lund studies in economics and management, ISSN 0284-5075 ; 127
Keyword
Public sector organizations, Primary health care, Hospital Health care, Clinical directors, Budgetary control
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Business Administration
Research subject
Economy, Business administration
Identifiers
urn:nbn:se:lnu:diva-41058 (URN)9789185113538 (ISBN)9185113530 (ISBN)
Public defence
2012-05-25, EC3:211 Holger Crafoords Ekonomicentrum, Ekonomihögskolan, Lund, 10:15
Opponent
Supervisors
Available from: 2015-03-31 Created: 2015-03-20 Last updated: 2015-03-31Bibliographically approved

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CiteExportLink to record
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Citation style
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