The British Accounting Review

Performance Measurement, Sustainability and Governance in the Healthcare Sector

Performance Measurement, Sustainability and Governance in the Healthcare Sector

Interdisciplinary accounting research in topics related to performance measurement, sustainability and governance in healthcare organizations in general, and in light of the COVID-19 pandemic in particular, remains scarce. Pre-pandemic accounting research has explored the role of accounting in financial crises (e.g., Bracci et al., 2015) and natural disasters (e.g., Sargiacomo, 2014; Sargiacomo et al., 2021), while recent studies emphasize how accounting is implicated in the management of the COVID-19 pandemic in institutional settings such as Governments, municipalities, non-governmental organizations (NGOs) and museums (Agostino et al., 2020; Leoni et al., 2021; 2022), yet a surprising paucity of accounting research in healthcare settings remains (e.g., Huber et al., 2021). The COVID-19 pandemic has further emphasized the importance of investigating performance measurement, sustainability and governance issues in healthcare organizations. In fact, this sector has taken on a "new" centrality following the pandemic’s onset, showing more than ever its importance for health, its weaknesses in a fast and interconnected world, the need to accelerate its attention to the digital world, and the need for governance that goes beyond the single organization.

Guest Editors:

Salma Ibrahim, Kingston University, UK, [email protected]

Christos Begkos, University of Manchester, UK, [email protected]

Michela Arnaboldi, Politecnico di Milano, Italy, [email protected]

Cameron Graham, York University, Canada, [email protected]

Rationale and Scope:

The COVID-19 pandemic has highlighted international differences in the performance, sustainability and governance of healthcare organizations. Specifically, the additional cost of the pandemic on the healthcare system, in the form of screening, diagnosis and case management, has been substantial both in advanced and low-income economies, but to different degrees (Kaye et al., 2021; Torres-Rueda et al, 2021). In addition, sustainability in terms of reduced bed capacity, insufficient testing systems and equitable access to vaccines across different countries have been of the utmost concern (Macassa & Tomaselli, 2020; Eccleston-Turner & Upton, 2021).

Prior literature on performance measurement in healthcare settings tends to discuss multiple dimensions of hospital or healthcare organization performance such as efficiency, effectiveness and flexibility (e.g., Purbey et al., 2007). One important aspect within this broad topic focuses on costing and hospital reimbursement. Although healthcare systems around the world are inherently different, certain similarities exist. For example, the English National Health Service (NHS) employs Healthcare Resource Groups[1] (HRGs) to set reimbursement tariffs, thus displaying similar characteristics with funding systems that are based on Diagnosis Related Groups (DRGs), such as France, Germany, Austria, Sweden, Finland, Portugal, Italy, Australia and New Zealand (e.g., Busse et al., 2013). Pre-pandemic studies suggest that such cost-based funding systems benefit standardized treatments, disadvantage complex and emergency care, truncate management control and incentivize privatized care (Chapman et al., 2014; Llewellyn et al., 2020). Such implications may constitute cost-based funding systems untenable in light of national care crises. Thus, the investigation of performance measurement and costing practices in post-pandemic healthcare settings is important to shed light on how to reimburse complex, emergency care more accurately and fairly.

Another commonly investigated angle in prior research around performance measurement is financial reporting, with a focus on incentives that drive alternative forms of reporting. However, the findings are mixed and the evidence scarce. Some studies find that hospitals want to avoid reporting losses or excessive profits to appease their stakeholders (e.g., Leone and Van Horn, 2005; Eldenburg et al., 2011). Other findings suggest managers wish to report a smooth stream of profits to avoid scrutiny by the government, to avoid manager turnover and to reduce the cost of debt if the hospital relies on loans (Boterenbrood, 2014). Therefore, there is a need to advance knowledge in this area, to understand the incentives that drive financial reporting and operating decisions within the healthcare sector.

Research on sustainability and governance in healthcare organizations, while linked to the above-mentioned streams of research is separately investigated in terms of long-term financial performance. However, studies tend to be limited to non-business journals and therefore focus on medical issues (e.g., Lydon et al., 2008; Lu and Cohen, 2015) or contain limited discussions of accounting issues (e.g., Kruse and Jeurissen, 2020; Mills and Kanavos, 2020). Some studies on governance rely on country-level data, with limited insight into individual hospital management (e.g., Sharma et al., 2021).

In practice, there is ample evidence that sustainability and governance of healthcare systems is an important issue to consider from an interdisciplinary accounting perspective to understand the financial implications of alternative strategies. In the UK, over the last two decades, government reforms introduced efficiency measures and drastic spending cuts to close a funding gap of £30bn by 2021 (NHS England, 2013), which impacted long-term sustainability in the healthcare sector. Other government initiatives that aimed to encourage hospitals’ financial autonomy included the introduction of Payment by Results (PbR), a funding system that reimburses hospitals based on clinical activity, and various performance management and measurement tools such as Service Line Reporting and Patient-level Information and Costing Systems (Llewellyn et al., 2016; Begkos & Antonopoulou, 2021). However, the COVID-19 pandemic brought further strain and exacerbated the financial woes within this important sector. Since the onset of the pandemic, the National Health Service in the UK faced severe long-term pressures as it lacked a national strategy for dealing with health inequalities (Fichera, 2020).Therefore, research on issues of performance measurement, sustainability and governance in the healthcare sector both before and following the pandemic is crucial yet underexplored.

The aim of this special issue is to publish a collection of papers that focus on key questions related to performance measurement, sustainability and governance within the healthcare sector, and especially in response to the COVID-19 pandemic.

The Editors are interested in articles that focus on advancing our theoretical understanding and addressing policy issues in these crucial, yet under-researched themes. Below are some examples of topics that would be considered for the special issue.

• Performance measurement practices in healthcare during the COVID-19 pandemic
• Healthcare costing techniques for the increase of public value
• Digitization and performance measurement technologies within healthcare settings
• Alternative costing of healthcare services
• Engagement of front-line professionals with costing and cost containment practices in healthcare settings
• Incentives embedded within healthcare systems that drive financial reporting decisions
• External accountability and communication across and after the COVID-19 pandemic: change, stability and international diversity
• Accountability for healthcare outcomes in private, for-profit healthcare
• Long-term financial sustainability of healthcare systems following the COVID-19 pandemic
• International differences in sustainability of healthcare systems
• Environmental sustainability of healthcare systems and possible change of priorities in light of climate change initiatives
• Changes in corporate governance mechanisms of healthcare systems following the COVID-19 pandemic
• Environmental, social and governance (ESG) performance and disclosure by healthcare institutions
• Government authority and the digital media role in healthcare disclosures
• International differences in governance structure of healthcare institutions

We are also open to other topics which fit the underlying general themes of this special issue.

Manuscript submission information:

Key Dates:

May 31, 2023: Deadline for submitting draft papers via Editorial Manager

June 2023 - June 2024: Review process and selection of articles to include in the special issue

It is anticipated that this special issue will be published in 2024.

Keywords:

· Public health systems

· Private health systems

· Pandemic response

· Post-pandemic healthcare costing systems

· Healthcare governance

· Digitization technologies

· Sustainability

· Performance management

· Performance measurement

· Cost Management

· Environmental impact

· Financial sustainability

· Climate change adaptation

· National Health Service

· Accountability

References:

Agostino, D., Arnaboldi, M., & Lema, M. D. (2021). New development: COVID-19 as an accelerator of digital transformation in public service delivery. Public Money & Management, 41(1), 69-72.

Boterenbrood, R. (2014). Income smoothing by Dutch hospitals, Journal of Accounting and Public Policy, 33(5), 510-524.

Bracci, E., Humphrey, C., Moll, J. and Steccolini, I. (2015), Public sector accounting, accountability and austerity: more than balancing the books?, Accounting, Auditing and Accountability Journal, 28(6), 878-908.

Begkos, C., & Antonopoulou, K. (2021). Hybridization as practice: clinical engagement with performance metrics and accounting technologies in the English NHS. Accounting, Auditing and Accountability Journal. In press.

Busse R, Geissler A, Aaviksoo A, Cots F, HÃkkinen U, Kobel C et al. (2013). Diagnosis related groups in Europe: moving towards transparency, efficiency, and quality in hospitals? BMJ, 346.

Chapman, C., Kern, A. & Laguecir, A. (2014). Costing practices in healthcare, Accounting Horizons, 28(2), 353-364.

Eccleston‐Turner, M., & Upton, H. (2021). International Collaboration to Ensure Equitable Access to Vaccines for COVID‐19: The ACT‐Accelerator and the COVAX Facility. The Milbank Quarterly, 99(2), 426-449.

Eldenburg, L. G., Gunny, K. A., Hee, K. W., & Soderstrom, N. (2011). Earnings management using real activities: Evidence from nonprofit hospitals. The Accounting Review, 86(5), 1605-1630.

Fichera, E. (2020). Coronavirus and the NHS: a big dose of cash is welcome, but not enough on its own. The Conversation, March 12, 2020, available at: https://theconversation.com/coronavirus-and-the-nhs-a-big-dose-of-cash-is-welcome-but-not-enough-on-its-own-133550.

Huber, C., Gerhardt, N. and Reilley, J.T. (2021). Organizing care during the COVID-19 pandemic: the role of accounting in German hospitals, Accounting, Auditing & Accountability Journal, 34(6), 1445-1456. https://doi.org/10.1108/AAAJ-08-2020-4882.

Kaye, A. D., Okeagu, C. N., Pham, A. D., Silva, R. A., Hurley, J. J., Arron, B. L., Sarfraz, N., Lee, H. N., Ghali, G. E., Gamble, J. W., Liu, H., Urman, R. D., & Cornett, E. M. (2021). Economic impact of COVID-19 pandemic on healthcare facilities and systems: International perspectives. Best practice & research. Clinical anaesthesiology, 35(3), 293–306. https://doi.org/10.1016/j.bpa.2020.11.009.

Kruse, F.M. & Jeurissen, P.P.T. (2020). For-profit hospitals out of business? Financial sustainability during the COVID-19 epidemic emergency response." International journal of health policy and management 9.10 (2020), 423-428.

Leone, A. J., & Van Horn, R.L. (2005). How do non-profit hospitals manage earnings? Journal of Health Economics, 24(4), 815-837.

Leoni, G., Lai, A., Stacchezzini, R., Steccolini, I., Brammer, S., Linnenluecke, M. and Demirag, I. (2021). Accounting, management and accountability in times of crisis: lessons from the COVID-19 pandemic, Accounting, Auditing and Accountability Journal, 34(6), 1305-1319.

Leoni, G., Lai, A., Stacchezzini, R., Steccolini, I., Brammer, S., Linnenluecke, M. and Demirag, I. (2022), The pervasive role of accounting and accountability during the COVID-19 emergency, Accounting, Auditing & Accountability Journal, 35(1), 1-19.

Llewellyn, S., Chambers, N., Ellwood, S., Begkos, C. & Wood, C. (2016), Patient Level Information and Costing Systems (PLICS): Current Practice and Future Potential for the NHS Health Economy, Health Services and Delivery Research. 4(31).

Llewellyn, S., Begkos, C., Ellwood, S., & Mellingwood, C. (2020). Public value and pricing in English hospitals: Value creation or value extraction? Critical Perspectives on Accounting, 102247.

Lu, C. Y., & Cohen, J. P. (2015). Can genomic medicine improve financial sustainability of health systems?. Molecular Diagnosis & Therapy, 19(2), 71-77.

Lydon, P., Levine, R., Makinen, M., Brenzel, L., Mitchell, V., Milstien, J. B., ... & Landry, S. (2008). Introducing new vaccines in the poorest countries: what did we learn from the GAVI experience with financial sustainability?. Vaccine, 26(51), 6706-6716.

Macassa, G., & Tomaselli, G. (2020). Rethinking developed nations' health systems through a social sustainability perspective in the light of the COVID-19 pandemic. A viewpoint. Journal of public health research, 9(4), 1834. https://doi.org/10.4081/jphr.2020.1834.

Mills, M., & Kanavos, P. (2020). Do pharmaceutical budgets deliver financial sustainability in healthcare? Evidence from Europe. Health Policy, 124(3), 239-251.

NHS England (2013). The NHS Belongs to the People: A Call to Action, NHS England, London.

Purbey, S., Mukherjee, K. and Bhar, C. (2007). Performance measurement system for healthcare processes, International Journal of Productivity and Performance Management, Vol. 56 No. 3, pp. 241-251.

Sargiacomo, M. (2014). Accounting for natural disasters and humanitarian interventions, Critical Perspectives on Accounting, 25(7), 576-578.

Sargiacomo, M., Servalli, S., Potito, S., D'Andreamatteo, A. and Gitto, A. (2021). Accounting for natural disasters from a historical perspective: a literature review and research agenda, Accounting History, 26(2), 179-204.

Sharma, A., Borah, S. B., & Moses, A. C. (2021). Responses to COVID-19: The role of governance, healthcare infrastructure, and learning from past pandemics. Journal of business research, 122, 597-607.

Torres-Rueda S., Sweeney S., Bozzani F., et al. (2021). Stark choices: Exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries. BMJ Global Health, 6:e005759.

Learn more about the benefits of publishing in a special issue: https://www.elsevier.com/authors/submit-your-paper/special-issues

Interested in becoming a guest editor? Discover the benefits of guest editing a special issue and the valuable contribution that you can make to your field: https://www.elsevier.com/editors/role-of-an-editor/guest-editors

Corporate Governance and Social Responsibility in China

OVERVIEW: In recent years, much research has been published about corporate governance in mainland China. Representative papers include Jiang, Lee, and Yue (2010), Jiang, Wan, and Zhao (2016), and Liao, Liu, and Wang (2014). In addition, Jiang and Kim (2015) compile a special issue on corporate governance in China, and more recently He and Wang (2022) compile a special issue about China with some papers focusing on corporate governance. The British Accounting Review (BAR) has also published excellent papers on corporate governance in China (e.g., Hou, Kuo, and Lee, 2012; Wei and Xiao, 2009). This research has primarily focused on the agency problems of controlling shareholders and state-owned enterprises (SOEs) and the efficacy of internal and external monitors, the role of political and social connections, and the effectiveness of laws, institutions, and new regulations (see Jiang and Kim (2020) and Wong (2016) for surveys of this literature, and Mutlu, Van Essen, Peng, Saleh, and Duran (2018) for a meta-analysis of this literature). Given that China has ambitious climate goals, recent papers have studied CSR and ESG in China (e.g., Bartling, Weber, and Zhao, 2014; Chen, Hung, and Wang, 2018; Zhang, Chan, and Guo, 2018) and some of those papers are also published in BAR (e.g., Qian and Chen, 2021).

However, as China continues to transition from a planned economy to a market economy, corporate governance regulations and practices in China change rapidly. What are current corporate governance practices in China? Are internal and external monitors becoming more effective or less effective at monitoring? Are recent corporate governance reforms and regulations working as intended? Is corporate governance in China unique or do other countries have similar corporate governance issues and practices? Are institutional investors becoming more important as monitors? Given China’s anti-corruption campaign, is it still important for firms to have political connections (if not, then what, if anything, has replaced them)? How do SOEs currently balance a profit objective and state objectives? Are Chinese firms adopting CSR and ESG practices (and if so, then what have been the effects)? The purpose of this special issue is to improve our understanding of these issues.

TOPICS: Paper topics for the special issue can include, but are not limited to:

· Recent corporate governance reforms and regulations in China.

· Corporate governance of SOEs.

· CSR and ESG in China.

· Role of political connections and social connections for Chinese firms.

· Comparative corporate governance to China.

· Institutional investors in China.

· What managerial incentives are used in China, and do they work?

· What is the current state of China’s market for corporate control?

· What is the current state of China’s market for outside CEOs and independent directors?

· What role do banks, as large creditors, play in corporate governance?

· Board structure and board composition in China.

· Ownership structure of firms in China.

· Corporate governance of family firms and private firms in China.

· Public and private securities regulations enforcement in China.

SUBMISSION PROCEDURE: To submit a paper to the special issue, go to the British Accounting Review webpage and follow the usual submission procedures. However, while in the Editorial Manager System, when you get to the dropdown menu to indicate your paper submission type, choose “VSI: CG in China.”

SUBMISSION DEADLINE: February 1, 2023.

ABOUT THE BRITISH ACCOUNTING REVIEW (BAR)

The British Accounting Review is the official journal of the British Accounting and Finance Association. It attained a CiteScore of 7.3 and an Impact Factor of 4.761 for 2021. These rank the journal in the top 3 and 6, respectively, among all accounting journals. Since 2017, it has been placed in Quartile 1 among accounting and finance journals. It is rated A* in the ABDC Journal Quality Guide and 3 in the ABS Academic Journal Guide.

Guest editors:

Dr. Fuxiu Jiang

Renmin University of China

Dr. Kenneth A. Kim 

Tongji University and State University of New York at Buffalo

Manuscript submission information:

The Journal’s submission system will be open for submissions for the Special Issue ‘Corporate Governance and Social Responsibility in China’. When submitting your manuscript please select the article type “VSI: CG in China”. Please submit your manuscript before 1^st February 2023.

All submissions deemed suitable to be sent for peer review will be reviewed by at least two independent reviewers.

Once your manuscript is accepted, it will go into production and will be simultaneously published in the current regular issue and pulled into the online Special Issue. Articles from this Special Issue will appear in different regular issues of the journal, though they will be clearly marked and branded as Special Issue articles.

Please see an example here: https://www.sciencedirect.com/journal/science-of-the-total-environment/special-issue/10SWS2W7VVV

Please ensure you read the Guide for Authors before writing your manuscript.

The Guide for Authors: https://www.editorialmanager.com/ybare/default1.aspx

The link to submit your manuscript is available on the Journal’s homepage at: https://www.elsevier.com/journals/the-british-accounting-review/0890-8389/guide-for-authors

Inquiries, including questions about appropriate topics, may be sent electronically to [email protected]

References:

Bartling, B., Weber, R. A., and Yao, L. (2014) Do markets erode social responsibility? Quarterly Journal of Economics 130, 219–266.

Chen, Y. C., Hung, M., and Wang, Y. (2018) The effect of mandatory CSR disclosure on firm profitability and social externalities: Evidence from China, Journal of Accounting and Economics 65, 169–190.

He, Z. and Wang, Y. (2022) Introduction: Special issue on China I, Review of Finance 26, 445–447.

Hou, W., Kuo, J-M, and Lee, E. (2012) The impact of state ownership on share price informativeness: The case of the split share structure reform in China, British Accounting Review 44, 248–261.

Jiang, F. and Kim, K. A. (2015) Corporate governance in China: A modern perspective, Journal of Corporate Finance 32, 190–216.

Jiang, F. and Kim, K. A. (2020) Corporate governance in China: A survey, Review of Finance 24, 733–772.

Jiang, G., Lee, C. M. C., and Yue, H. (2010) Tunneling through intercorporate loans: The China experience, Journal of Financial Economics 98, 1–20.

Jiang, W., Wan, H., and Zhao, S. (2016) Reputation concerns of independent directors: Evidence from individual director voting, Review of Financial Studies 29, 655–696.

Liao, L., Liu, B., and Wang, H. (2014) China’s secondary privatization: Perspectives from the split-share structure reform, Journal of Financial Economics 113, 500–518.

Mutlu, C. C., Van Essen, M., Peng, M. W., Saleh, S. F. and Duran, P. (2018) Corporate governance in China: A meta-analysis, Journal of Management Studies 55, 943–979.

Qian, W. and Chen, X. (2021) Corporate environmental disclosure and political connection in regulatory and leadership changes: The case of China, British Accounting Review 53, 100935.

Wei, G. and Xiao, J. Z. (2009) Equity ownership segregation, shareholder preferences, and dividend policy in China, British Accounting Review 41, 169–183.

Wong, T. J. (2016) Corporate governance research on listed firms in China: institutions, governance and accountability, Foundations and Trends in Accounting 9, 259–326.

Zhang, B., Chen, X., and Guo, H. (2018) Does central supervision enhance local environmental enforcement? Quasi-experimental evidence from China, Journal of Public Economics 164, 70–90.

Learn more about the benefits of publishing in a special issue: https://www.elsevier.com/authors/submit-your-paper/special-issues

Interested in becoming a guest editor? Discover the benefits of guest editing a special issue and the valuable contribution that you can make to your field: https://www.elsevier.com/editors/role-of-an-editor/guest-editors