Accountingization, trust and medical dilemmas.
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.
Lapsley
Irvine
I
University of Edinburgh, Edinburgh, UK. I.Lapsley@ed.ac.uk
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