Cost Management Reform from the Perspective of Structural Theory: Empirical Findings of a Public Hospital

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Journal of Central University of Finance & Economics ›› 2022, Vol. 0 ›› Issue (3) : 59-68.

LIU Jun-yong, AN Na, DUAN Wen-xuan, LIU Jia-qi

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Abstract

This paper takes a public hospital A in a city as the research object,adopts a single case study method and discusses the practice of cost management reform under the background of DRG payment from the perspective of structural theory.This paper investigates the institutional factors in the process of cost management reform and the behavior response of the reformers embedded in the system.The study finds that hospital A did not follow the original intention of policy makers to use activity-based costing as the cost management method to formulate the disease group's cost,however used the place-based costing where the cost occurs.The main reasons for this loose coupling phenomenon are:first,the inherent practice leads to the semantic structure focusing on the department and the place where the cost occurs;second,the lack of resource allocation power of the financial department leads to great resistance to the implementation of change;third,the restriction of information technology and the vague cognition of the role of change leaders lead to the higher legitimacy of the place-based costing.Using the structural theory,this paper makes an in-depth analysis of the above reasons,which not only expands the application scenario of the structural theory,but also provides a reference for organizations to carry out cost management reform and digital transformation.

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Cost management change / DRG payment / Structural theory

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LIU Jun-yong, AN Na, DUAN Wen-xuan, LIU Jia-qi. Cost Management Reform from the Perspective of Structural Theory: Empirical Findings of a Public Hospital[J]. Journal of Central University of Finance & Economics, 2022, 0(3): 59-68

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