RESUMO
Existing management information systems (MIS) in hospitals are often inadequate. This has occurred because of a variety of antecedents, including past funding mechanisms, organisational structure and the accepted role of management. A variety of new pressures, including demands for increased accountability, greater resource control and changing relationships between physicians and hospitals are demanding improved MIS to enable the hospital to manage. This paper explores these influences on past and future hospital MIS. It describes the design of a MIS that enables patient care to be costed in clinically meaningful ways. Patient costs may be aggregated to cost specific diagnoses and procedures, Diagnosis Related Groups (DRG), a clinician's case load, a clinical unit or a division. The information can be used for clinical budgeting, flexible budgeting, utilisation review and quality assurance.
Assuntos
Departamentos Hospitalares/economia , Hospitais Públicos/organização & administração , Sistemas de Informação Administrativa , Austrália , Orçamentos , Sistemas Computacionais , Alocação de Custos , Grupos Diagnósticos Relacionados/economiaRESUMO
This is the second of a series of articles describing the cost models developed as part of the new computerised Clinical Information System (CIS) at the Queen Victoria Medical Centre campus of the Monash Medical Center in Melbourne. The first article in this series described the costing of diagnostic laboratory services. This paper provides a brief overview of the CIS and describes the costing of services in the Medical Imaging Division.
Assuntos
Contabilidade/métodos , Custos e Análise de Custo/métodos , Diagnóstico por Imagem/economia , Departamentos Hospitalares/economia , Modelos Teóricos , Serviço Hospitalar de Radiologia/economia , Medicina Nuclear/economia , Admissão e Escalonamento de Pessoal/economia , Ultrassonografia/economia , VitóriaRESUMO
Professional/bureaucratic conflict theory suggests that the extent to which nurse managers use management control systems will depend on whether their goal orientation is to system rather than output or derived goals. This article examines the use of budgeting as a management control strategy, in relation to the goal orientation of nurse managers, in four large teaching hospitals. The goal orientations and use of budgeting by nurse managers is also compared with those of physician managers and other sub-unit managers. The results indicate that nurse managers appear to be developing their goals of professionalization without a diminution of their organizational focus or their orientation towards providing a high standard of patient care.
