Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
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Perception of Korean Hospital CEOs on Organizational Accountability : Findings from In-Depth Interviews

한국 병원 최고 경영자의 책무성 인식 : 심층 면접 결과를 중심으로

  • You, Myoungsoon (Graduate School of Public Health, Seoul National University) ;
  • Lee, Geunchan (Graduate School of Public Health, Seoul National University) ;
  • Kwon, Soonman (Graduate School of Public Health, Seoul National University) ;
  • Yoon, Hyejung (Graduate School of Public Health, Seoul National University)
  • Received : 2012.10.10
  • Accepted : 2012.12.12
  • Published : 2012.12.31
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Abstract

As misalignments among images, identity, and legitimacy of health professionals and institutions have been on the rise, CEOs of health care organizations have been required to enhance organizational accountability. Despite the accumulation of literature on the conceptual discussions of accountability, only a few studies empirically investigated key barriers to accountability and its facilitators. To identify perception on accountability with key barriers and facilitators of organizational accountability, a semi-structured interview with 11 CEOs of Korean hospitals was conducted. A short survey was taken to get quantitative data on CEO's perception on organizational accountability. To CEOs, accountability was very complex and unfamiliar concept, but understood as physician's code of ethics by nature and basic principle of hospital management. CEOs thought accountability could be improved through ethical leadership, financial stability and learning climate of hospitals. Distrust of the government, which failed to provide economic incentives for hospitals to increase accountability activities, was emphasized as a serious barrier to hospital accountability. There was consensus among hospital CEOs as to the importance of accountability in management. However, there were concerns that, without policy instruments to motivate hospitals toward increasing community benefits as well as collective efforts among health professionals to rebuild moral climate for being accountable, greater accountability would not be achieved in hospitals.

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References

  1. 강정대. 현대경영조직론, 서울: 박영사; 2003.
  2. 권오성, 황혜신, 박석희, 김철회. 공공기관의 책임성 유형과 우선순위에 관한 실증분석. 한국사회와 행정연구 2009; 20(1): 51-74.
  3. 알랜 래들리(Alan Radley) 지음. 조병희, 전신현 공역. 질병의 사회심리학. 서울: 나남; 2004.
  4. 이근찬, 유명순. 의료기관의 조직 책무성: 분석을 위한 모형 개발. 보건행정학회지 2011; 21(2): 213-248. https://doi.org/10.4332/kjhpa.2011.21.2.213
  5. 조병희. 의료문제의 사회학. 서울: 태일사; 2000.
  6. Anwar S. Clinical Governance: The Concept of Accountability in the Practise of Medicine. The Journal of the Pakistan Medical Association 2011;61(3): 208-209.
  7. Bardach E, Lesser C. (1996). Accountability in Human Services Collaboratives? For What? And to Whom? Journal of Public Administration Research and Theory 1996; 6(2): 197-224. https://doi.org/10.1093/oxfordjournals.jpart.a024307
  8. Bovens M. Analysing and Assessing Accountability: A Conceptual Framework. European Law Journal 2007; 13(4): 447-468. https://doi.org/10.1111/j.1468-0386.2007.00378.x
  9. Brinkerhoff DW. Accountability and Health Systems: Toward Conceptual Clarity and Policy Relevance. Health Policy Plan 2004; 19(6): 371-379. https://doi.org/10.1093/heapol/czh052
  10. Day P, Klein R. Accountabilities: Five Public Services. London: Taylor & Francis; 1987.
  11. Dubnick MJ, O' Brien J. Rethinking the Obsession: Accountability and the Financial Crisis. In Dubnick MJ, Frederickson HG editors, Accountable Governance: Problems and Promises. London: M.E. Sharpe; 2011.
  12. Dubnick MJ. The Rhetoric and Promises of Accountability. Netherlands. Remarks prepared for presentation at Leiden University; 2002.
  13. Dubnick MJ, Romzek BS. American Public Administration: Politics and the Management of Expectations. NY: Macmillan; 1991.
  14. Emanuel EJ, Emanuel LL. What is Accountability in Health Care? Annals of Internal Medicine 1996; 124(2): 229-239. https://doi.org/10.7326/0003-4819-124-2-199601150-00007
  15. Etzioni A. Alternative Conceptions of Accountability. Hospital progress 1974;55(7): 56-59.
  16. Fisher ES, McClellan MB, Bertko J, Lieberman SM, Lee JJ, Lewis JL, Skinner, JS. Fostering Accountable Health Care: Moving Forward in Medicare. Health Affairs 2009; 28(2): 219-231. https://doi.org/10.1377/hlthaff.28.2.w219
  17. Gamm LD. Dimensions of Accountability for Not-For-Profit Hospitals and Health Systems. Health Care Management Review 1996; 21(2): 74-86. https://doi.org/10.1097/00004010-199605000-00009
  18. Garfinkel H. Studies in Ethnomethodology. NJ:Englewood Cliffs; 1967.
  19. Goddard A. Accounting and NPM in UK Local Government-Contributions Towards Governance and Accountability. Financial Accountability & Management 2005; 21(2): 191-218. https://doi.org/10.1111/j.1468-0408.2005.00215.x
  20. Hoek F, Van Montfort C, Vermeer C. Enhancing public accountability in the Netherlands. OECD Journal on Budgeting 2005; 5(2): 69-86. https://doi.org/10.1787/budget-v5-art12-en
  21. Kelly SE. Qualitative Interviewing Techniques and Styles. In Bourgeault I, Dingwall R, De Vries R editors, The SAGE Handbook of Qualitative Methods in Health Research. Los Angeles: SAGE; 2011.
  22. Kjaer AM. Governance. Malden:Polity Press; 2004.
  23. Lindkvist L, Llewellyn S. Accountability, Responsibility and Organization. Scandinavian Journal of Management 2003; 19(2): 251-273. https://doi.org/10.1016/S0956-5221(02)00027-1
  24. Luke B. Examining Accountability Dimensions in State‐Owned Enterprises. Financial Accountability & Management 2010; 26(2): 134-162. https://doi.org/10.1111/j.1468-0408.2010.00496.x
  25. Magretta J. Why Business Models Matter. Harvard business review 2002; 80(5): 86-93.
  26. Monks R, Minow N. Corporate Governance. London:Cambridge;2004.
  27. Moorhead G, Griffin RW. Organizational Behavior: Managing People and Organizations. Boston: Houghton Mifflin; 2004.
  28. Mulgan RG. Holding Power to Account: Accountability in Modern Democracies. London: Palgrave Macmillan; 2003.
  29. Ospina S, Diaz W, O'Sullivan JF. Negotiating Accountability: Managerial Lessons from Identity-Based Nonprofit Organizations. Nonprofit and Voluntary Sector Quarterly 2002; 31(1): 5-31. https://doi.org/10.1177/0899764002311001
  30. Perakyla A. Authority and Accountability: The Delivery of Diagnosis in Primary Health Care. Social Psychology Quarterly 1998; 61(4): 301-320. https://doi.org/10.2307/2787032
  31. Pettersen IJ. Accountable Management Reforms: Why the Norwegian Hospital Reform Experiment Got Lost in Implementation. Financial Accountability & Management 1999; 15(34): 377-396. https://doi.org/10.1111/1468-0408.00090
  32. Razzaq A. Operating in the Dark: The Accountability Crisis in Canada's Healthcare System: A Review. Healthcare Quarterly 1998; 2(2): 72-73. https://doi.org/10.12927/hcq..16740
  33. Roberts J, McNulty T, Stiles P. Beyond Agency Conceptions of the Work of the Non-Executive Director: Creating Accountability in the Boardroom. British Journal of Management 2005; 16: S5-S26. https://doi.org/10.1111/j.1467-8551.2005.00444.x
  34. Roberts P. Turning Promises into Realities: a Guide to Implementing the Child Support Provisions of the Family Support Act of 1988. 2nd ed. Washington, D.C.: Center for Law and Social Policy; 1991.
  35. Robinson DZ. Government Contracting for Academic Research: Accountability in the American Experience. In Smith BLR, Hague DC editors, The Dilemma of Accountability in Modern Government: Independence versus Control. London: Macmillan; 1971.
  36. Romzek BS, Dubnick MJ. Accountability in the Public Sector: Lessons from the Challenger Tragedy. Public Administration Review 1987; 47(3): 227-238. https://doi.org/10.2307/975901
  37. Rose B, Chinitz D, Israeli A. Accountability in Health Care Reconsidered. In Rosen B, Istraeli A, Shortell SM editors, Accountability and Responsibility in Health Care. Singapore: World Scientific; 2012.
  38. Salimath MS, Jones III R. Population Ecology Theory: Implications for Sustainability. Management Decision 2011; 49(6): 874-910. https://doi.org/10.1108/00251741111143595
  39. Schneller ES, Wilson NA. Professionalism in 21st Century Professional Practice: Autonomy and Accountability in Orthopaedic Surgery. Clinical Orthopaedics and Related Research 2009; 467(10): 2561-2569. https://doi.org/10.1007/s11999-009-0836-4
  40. Scott MB, Lyman SM. Accounts, Deviance and Social Order. In Douglas JD editors, Deviance and Respectability. New York: Basic Books; 1970.
  41. Shaw C. External Assessment of Health Care. British Medical Journal 2001; 322(7): 851-854. https://doi.org/10.1136/bmj.322.7290.851
  42. Shortell SM, Gilles RR, Anderson DA. Remaking Health Care in America. 2nd ed. San Francisco: Jossey-Bass; 2000.
  43. Shortell SM, Kaluzny A. Health Care Management: Organization Design and Behavior. 4th ed. New York: Delmar Publishers; 2000.
  44. Shortell SM, Kaluzny A. Health Care Management: Organization Design and Behavior. 5th ed. New York: Delmar Publishers; 2006.
  45. Sinclair A. The Chameleon of Accountability: Forms and Discourses. Accounting, organizations and Society 1995; 20(2): 219-237. https://doi.org/10.1016/0361-3682(93)E0003-Y
  46. Trebilcock MJ, Iacobucci EM. Privatization and Accountability. Harvard Law Review 2002; 116: 1422.
  47. Wang X. Assessing Administrative Accountability. The American Review of Public Administration 2002; 32(3): 350-370. https://doi.org/10.1177/0275074002032003005
  48. Zahra SA, Pearce JA. Boards of Directors and Corporate Financial Performance: A Review and Integrative Model. Journal of Management 1989; 15(2): 291-334. https://doi.org/10.1177/014920638901500208

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