title: Accountingization, trust and medical dilemmas.
abstract: OBJECTIVE
  The purpose of this paper is to investigate the impact of accounting on clinical practices.
  
  
  METHODS
  This paper reviews existing studies of clinical budgeting, analyses publicly available data on cost-effectiveness recommendations for the NHS; analyses publicly available data on the influence of accounting in medical dilemmas.
  
  
  RESULTS
  The paper finds that there is limited evidence of clinical budgeting dominating clinical decisions, but there is some evidence of central agency directions on appropriateness of treatments, but this is on a cost-effectiveness basis. Numerous examples of adverse medical outcomes are cited in this paper--but with limited influence of accounting in these decisions.
  
  
  CONCLUSIONS
  The paper shows that the combination of accounting and medical data in a topical matter makes this an original and distinctive study.
authors.affiliation: University of Edinburgh, Edinburgh, UK. I.Lapsley@ed.ac.uk
authors.forename: Irvine
authors.initials: I
authors.lastname: Lapsley
mesh_terms: D000066:Accounting; D002017:Budgets; D032821:Commodification; D003362:Cost-Benefit Analysis; D003659:Decision Making, Organizational; D006801:Humans; D008505:Medical Staff, Hospital / Q000191:economics* / Q000941:ethics; D015279:Organizational Culture; D017063:Outcome Assessment, Health Care; D010817:Physician-Patient Relations; D012945:Social Values; D013222:State Medicine / Q000191:economics*; D035502:Trust; D006113:United Kingdom