Critical Perspectives on Sustainable Accountability in Inter-Organizational Management of Budget Cuts

Jean Claude Mutiganda, Giuseppe Grossi, Lars G Hassel

Research output: Chapter in Book/Conference proceedingConference contributionScientificpeer-review


This study analyses the relationship between institutionalization of budget cuts andsustainable accountability in public health care supply chain during the ongoing financial crisis. It uses the theory of negotiated order to extend the institutional framework of management accounting change proposed by Burns and Scapens (2000). Field research was conducted in Finland in two hospital districts, a local health care centre and a municipality, between 2012 and 2014. Data are based on document analysis and interviews with key decision makers and medical professionals.The study shows that medical professionals use a negotiated order approach amongthemselves to institutionalize budget cuts in in hospital districts, which leads to sustainable accountability. At municipal and regional levels, however, budgets of primary health care services suffer from suffocation caused by political pressure to cut costs without sustainable accountability mechanisms in the supply chain of health care services.Major contribution is to show how institutionalization of budgetary cuts in public health care cannot be taken for granted to save costs of health care services and improve sustainable accountability among political decision makers and medical professionals when the supply chain is not integrated. As in any other field study, however, our findings cannot be generalized to other organizations than the organizations analyzed.
Original languageUndefined/Unknown
Title of host publicationAnnual conference British Accounting and Finance Association (BAFA)
PublisherAnnual conference of british accounting and finance association
Publication statusPublished - 2015
MoE publication typeA4 Article in a conference publication
EventBAFA conference - British Accounting and Finance Association (BAFA) Annual Conference
Duration: 23 Mar 201525 Mar 2015


ConferenceBAFA conference


  • Accountability
  • Budget cuts
  • Institutionalization
  • Instrumental
  • Negotiated order
  • Sustainable

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