题名

總額預算制度下,醫師專業化程度、管理會計系統與預算控制行為之關聯性

并列篇名

The Relationship among Physicians' Professionalism, Management Accounting System and Budget Control Behavior under Global Budget System

DOI

10.6226/NTUMR.2015.Jun.R.11029

作者

李佳玲(Chia-Ling Lee);史雅男(Ya-Nan Shih);蕭詔芳(Chao-Fang Hsiao)

关键词

角色理論 ; 專業化 ; 管理會計系統 ; role theory ; professionalism ; management accounting systems

期刊名称

臺大管理論叢

卷期/出版年月

25卷2期(2015 / 06 / 01)

页次

119 - 148

内容语文

繁體中文

中文摘要

總額預算制度實施後,成本的控制與資源的分配即成為醫院營運的重要考量。醫院的營運受到醫師高度專業與自主性行為的影響,儘管如此,卻鮮少文獻探討透過管理會計系統使用如何影響醫師預算之控制行為。因此,本研究以角色理論為基礎,針對台灣個案醫院之醫師,進行問卷調查並輔以半結構化的訪談,探討醫師的專業化程度是否透過管理會計系統之使用,進而影響醫師的預算控制行為。本文以部分最小平方法分析92份有效問卷。實證結果發現,醫師專業化程度與預算控制行為呈現負向關聯性。然而,醫師的專業化程度透過廣範圍的管理會計系統以及互動式的管理會計系統使用之後,會促使醫師從事預算控制,顯示出醫師的專業化程度雖有害於預算控制,但透過管理會計系統的使用,卻進而正向促進其預算控制。實證結果支持本文所提出的論點。

英文摘要

When the global budget system is executed, cost control and resource allocation become important factors for the hospital operation. The operations of hospitals are influenced by physicians' behavior which are highly professional and autonomous. Whether physicians' budget control behavior is affected through the use of management accounting systems (MAS) which is seldom addressed despite significant evidence of its importance in hospital operation under global budget system. Based on role theory, this research analyzes the effect of the physicians' professionalism on their budget control behavior through the use of MAS. Our investigation is conducted using questionnaire survey and semi-structured interview in a regional teaching hospital of Taiwan. Final usable responses from 92 physicians are analyzed via partial least squares. The results indicate that physicians' professionalism is negatively associated with their budget control behavior. However, the physicians' professionalism will indirectly enhance budget control behavior via the use of broad-scope and interactive MAS. Although physician professionalism harms budget control, physician's budget control behavior is improved through the use MAS. The results support the theoretical model taken in the paper.

主题分类 基礎與應用科學 > 資訊科學
基礎與應用科學 > 統計
社會科學 > 經濟學
社會科學 > 財金及會計學
社會科學 > 管理學
参考文献
  1. 祝道松、倪豐裕、盧正宗(2010)。預算控制制度對醫院組織效能影響之探討-以角色壓力作為中介變數。會計評論,50,57-87。
    連結:
  2. 鍾紹熙、倪豐裕、蘇英芳、邱炳乾、蘇錦俊(2009)。策略型態對廣範圍管會系統、工作資訊認知與管理績效之關聯性的影響。交大管理學報,29(2),47-82。
    連結:
  3. Abbott, A.(1988).The System of Professions.Chicago, IL:University of Chicago Press.
  4. Abernethy, M. A.,Brownell, P.(1999).The role of budgets in organizations facing strategic change: An exploratory study.Accounting, Organizations and Society,24(3),189-204.
  5. Abernethy, M. A.,Guthrie, C. H.(1994).An empirical assessment of the "fit" between strategy and management information system design.Accounting and Finance,34(2),49-66.
  6. Abernethy, M. A.,Lillis, A. M.(2001).Interdependencies in organization design: A test in hospitals.Journal of Management Accounting Research,13(1),107-130.
  7. Abernethy, M. A.,Stoelwinder, J. U.(1995).The role of professional control in the management of complex organizations.Accounting, Organizations and Society,20(1),1-17.
  8. Abernethy, M. A.,Vagnoni, E.(2004).Power, organization design and managerial behaviour.Accounting, Organizations and Society,29(3-4),207-225.
  9. Bagozzi, R. P.,Yi, Y.(1988).On the evaluation of structural equation models.Journal of the Academic of Marketing Science,16(1),76-94.
  10. Baron, R. M.,Kenny, D. A.(1986).The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.Journal of Personality and Social Psychology,51(6),1173-1182.
  11. Bisbe, J.,Otley, D.(2004).The effects of the interactive use of management control systems on product innovation.Accounting, Organizations and Society,29(8),709-737.
  12. Bouwens, J.,Abernethy, M. A.(2000).The consequences of customization of management accounting system design.Accounting, Organizations and Society,24(2),221-241.
  13. Callister, R. R.,Wall, J. A.(2001).Conflict across organizational boundaries: Managed care organizations versus health care providers.Journal of Applied Psychology,86(4),754-763.
  14. Chenhall, R. H.(2003).Management control systems design within its organizational context: Findings form contingency-based research and directions for the future.Accounting, Organizations and Society,28(2-3),127-168.
  15. Chenhall, R. H.,Morris, D.(1991).The effect of cognitive style and sponsorship bias on the treatment of opportunity costs in resource allocation decisions.Accounting, Organizations and Society,16(1),27-46.
  16. Chong, V. K.(1996).Management accounting systems, task uncertainty and managerial performance: A research note.Accounting, Organizations and Society,21(5),415-421.
  17. Chow, C. W.,Ganulin, D.,Haddad, K.,Williamson, J.(1998).The balanced scorecard: A potential tool for energizing and focusing healthcare organizational management.Journal of Healthcare Management,43(3),263-280.
  18. Davila, A.,Foster, G.(2005).Management accounting systems adoption decisions: Evidence and performance implications from early-stage/startup companies.Accounting Review,80(4),1039-1068.
  19. Davila, T.,Wouters, M.(2005).Managing budget emphasis through the explicit design of conditional budgetary slack.Accounting, Organization and Society,30(7-8),587-608.
  20. Dunk, A. S.(1989).Budget emphasis, participation and managerial performance: A note.Accounting, Organization and Society,14(4),321-324.
  21. Durand, R.(2003).Predicting a firm's forecasting ability: The role of organizational illusion of control and organizational attention.Strategic Management Journal,24(9),821-838.
  22. Dwivedula, R.,Bredillet, C. N.(2010).The relationship between organizational and professional commitment in the case of project workers: Implications for project management.Project Management Journal,41(4),79-88.
  23. Eldenburg, L.,Soderstrom, N.,Willis, V.,Wu, A.(2010).Behavioral changes following the collaborative development of an accounting information system.Accounting, Organizations and Society,35(2),222-237.
  24. Evetts, J.(2006).Short note: The sociology of professional groups.Current Sociology,54(1),133-143.
  25. Fisher, J.(1995).Contingency-based research on management control systems: Categorization by level of complexity.Journal of Accounting Literature,14,24-53.
  26. Fornell, C.,Larcker, D. F.(1981).Evaluating structural equation models with unobservable variables and measurement error.Journal of Marketing Research,18(1),39-50.
  27. Fowkes, F.(1985).Doctor's knowledge of the costs of medical care.Medical Education,19(2),113-117.
  28. Hair, J. F.,Amderson, R. E.,Tatham, R. L.,Black, W. C.(1998).Multivariate Data Analysis.Englewood Cliffs, NJ:Prentice-Hall.
  29. Hall, R. H.(1967).Some organizational considerations in the professional-oriented relationship.Administrative Science Quarterly,12(3),461-478.
  30. Henri, J. F.(2006).Management control systems and strategy: A resource-based perspective.Accounting, Organizations and Society,31(6),529-558.
  31. Hopwood, A. G.(1976).Accounting and Human Behavior.Englewood Cliffs, NJ:Prentice Hall.
  32. Hoyle, R.(Ed.)(1999).Statistical Strategies for Small Sample Research.Thousand Oaks, CA:Sage Publications.
  33. Hunton, J. E.,Gibson, D.(1999).Soliciting user-input during the development of an accounting information system: Investigating the efficacy of group discussion.Accounting, Organizations and Society,24(7),597-618.
  34. Jarzabkowski, P.,Searle, R. H.(2004).Harnessing diversity and collective action in the top management team.Long Range Planning,37(5),399-419.
  35. Jensen, M.,Zajac, E. J.(2004).Corporate elites and corporate strategy: How demographic preferences and structural positions shape the scope of the firm.Strategic Management Journal,25(6),507-524.
  36. Jones, C. S.,Dewing, I. P.(1997).The attitudes of NHS clinicians and medical managers towards changes in accounting controls.Financial Accountability and Management,13(3),261-280.
  37. Kaiser, H. F.(1974).An index of factorial simplicity.Psychometerika,39(1),31-36.
  38. Lau, C. M.,Wong, K. M.,Eggleton, I. R. C.(2008).Fairness of performance evaluation procedures and job satisfaction: The role of outcome-based and non-outcomebased effects.Accounting and Business Research,38(2),121-135.
  39. March, J. G.(Ed.)(1965).Handbook of Organizations.Chicago, IL:Rand McNally.
  40. Marjoribanks, T.,Lewis, J. M.(2003).Reform and autonomy: Perceptions of the Australian general practice community.Social Science and Medicine,56(10),2229-2239.
  41. Mia, L.,Chenhall, R. H.(1994).The usefulness of management accounting systems, functional differentiation and managerial effectiveness.Accounting, Organizations and Society,19(1),1-13.
  42. Mia, L.,Winata, L.(2008).Manufacturing strategy, broad scope MAS information and information and communication technology.British Accounting Review,40(2),182-192.
  43. Mills, P. K.(1983).Self-management: Its control and relationship to other organizational properties.Academy of Management Review,8(3),445-453.
  44. Mintzberg, H.(2007).Mintzberg on Management: Inside Our Strange World of Organizations.New York, NY:Free Press.
  45. Mintzberg, H.(1990).The design school: Reconsidering the basic premises of strategic management.Strategic Management Journal,11(3),171-195.
  46. Mishra, S. K.,Satpathy, R.(2001).Reply to physicians' attitudes about prescribing and knowledge of the costs of common medications.Archives of Internal Medicine,161(10),1352-1353.
  47. Mundy, J.(2010).Creating dynamic tensions through a balanced use of management control systems.Accounting, Organizations and Society,35(5),499-523.
  48. Naranjo-Gil, D.,Hartmann, F.(2007).How CEO use management information systems for strategy implementation in hospitals.Health Policy,81(1),29-41.
  49. Naranjo-Gil, D.,Hartmann, F.(2007).Management accounting systems, top management team heterogeneity and strategic change.Accounting, Organizations and Society,32(7-8),735-756.
  50. Naranjo-Gil, D.,Hartmann, F.(2006).How top management teams use management accounting systems to implement strategy.Journal of Management Accounting Research,18(1),21-53.
  51. Nunnally, J. C.(1978).Psychometric Theory.New York, NY:McGraw-Hill.
  52. O'Connor, N. G.,Deng, J.,Luo, Y.(2006).Political constraints, organization design and performance measurement in China's state-owned enterprises.Accounting, Organizations and Society,31(2),157-177.
  53. Pizzini, M.(2006).The relation between cost-system design, managers' evaluations of the relevance and usefulness of cost data, and financial performance: An empirical study of US hospitals.Accounting, Organizations and Society,31(2),179-210.
  54. Podsakoff, P. M.,MacKenzie, S. B.,Podsakoff, N. P.(2003).Common method biases in behavioral research: A critical review of the literature and recommended remedies.Journal of Applied Psychology,88(5),879-903.
  55. Podsakoff, P. M.,Organ, D. W.(1986).Self-reports in organizational research: Problems and prospects.Journal of Management,12(4),531-544.
  56. Raelin, J. A.(1989).The Clash of Culture: Managers and Professionals.Boston, MA:Harvard Business School Press.
  57. Reichert, S.,Simon, T.,Halm, E. A.(2001).Physicians' attitudes about prescribing and knowledge of the costs of common medications.Archives of Internal Medicine,160(18),2799-2803.
  58. Ryan, M.,Yule, B.,Bond, C.,Taylor, R. J.(1996).Do physicians' perceptions of drug costs influence their prescribing?.PharmacoEconomics,9(4),321-331.
  59. Simons, R.(2000).Performance Measurement and Control Systems for Implementing Strategies.Upper Saddle River, NJ:Prentice Hall.
  60. Simons, R.(1995).Levers of Control: How Managers Use Innovative Control Systems to Drive Strategic Renewal.Boston, MA:Harvard Business School Press.
  61. Snizek, W. E.(1972).Hall's professionalism scale: An empirical reassessment.American Sociological Review,37(1),109-114.
  62. Stoelwinder, J. U.,Abernethy, M. A.(1989).The design and implementation of a management information system for Australian public hospitals.Health Services Management Research,2(3),176-190.
  63. Swieringa, R. J.,Moncur, R. H.(1972).The relationship between managers' budgetoriented behavior and selected attitude, position, size and performance measures.Journal of Accounting Research,10(1),194-209.
  64. Terris, M.(1991).Global budgeting and the control of hospital cost.Journal of Public Health Policy,12(1),61-71.
  65. Tordera, N.,González-Romá, V.,Peiró, J. M.(2008).The moderator effect of psychological climate on the relationship between leader-member exchange (LMX) quality and role overload.European Journal of Work and Organizational Psychology,17(1),55-72.
  66. Traynor, M.,Boland, M.,Buus, N.(2010).Professional autonomy in 21st century healthcare: Nurses' accounts of clinical decision-making.Social Science & Medicine,71(8),1506-1512.
  67. Walter, Z.,Lopez, M. S.(2008).Physician acceptance of information technologies: Role of perceived threat to professional autonomy.Decision Support Systems,46(1),206-215.
  68. Zucker, L. G.(1991).Markets for bureaucratic authority and control: Information quality in professions and services.Research in the Sociology of Organizations,8,157-l90.
  69. 陳端容(2007)。科技部補助研究報告科技部補助研究報告,科技部=Ministry of Science and Technology。
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