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Most literature on the antecedents of misreporting in the public sector focuses on the propensity to report financial breakeven, with limited attention to the regulatory and normative incentives that may alter such propensity. This study provides novel explanations for public sector organisations' deviation from breakeven. Its underlying assumption is that misreporting may be shaped by mimetic pressures encouraging conformity as well as regulatory pressures conveyed through soft budget constraints. The empirical analysis includes all Italian public healthcare organisations over 17 years. The findings suggest that public healthcare organisations may manipulate accruals not only to achieve financial breakeven, but also to conform with peers’ financial performance or to worsen reported financial performance in anticipation of a bailout.

This paper adds to literature on financial audit in public sector organizations. The authors examined the effect of adapting a private sector audit body—the Board of Statutory Auditors (BoSA)—for use by Italian public healthcare organizations. The research objective was to explore whether the characteristics generally required of private sector audit bodies (independence, accounting and financial expertise, industry specialization, diligence, and institutional support) are relevant to the public sector. Information on these characteristics was collected through an online questionnaire and used to explain audit quality. The results show the relevance of accounting and financial expertise, as well as industry specialization. The authors call for further research on the need for auditor independence in a public service setting.

L'indagine condotta dal Consiglio Direttivo AIDEA ha arricchito l'attuale conoscenza relativa ai percorsi dottorali italiani in materia economico-aziendale, ponendo le fondamenta per lo sviluppo di un profilo di indagine di carattere analitico ed interpretativo. La disomogeneità dei diversi contesti territoriali ha indotto delle riflessioni in merito all'opportunità di predisporre strategie di armonizzazione delle modalità di svolgimento dei corsi dottorali, seppur nel rispetto della valorizzazione delle identità culturali delle singole Scuole di Economia Aziendale che si sono sviluppate negli anni. La ricognizione e la consapevolezza delle diverse specificità, presupponendo un confronto fra gli attori in termini di modalità di somministrazione e contenuti dei vari insegnamenti, potrebbe contribuire ad un miglioramento degli standard qualitativi della formazione dei Dottorandi e, al contempo, favorire collaborazioni, condivisioni di corsi, iniziative di arricchimento trasversali.

This study contributes to the debate about control systems in the public sector by analyzing the characteristics and the activities of the Boards of Statutory Auditors in the Italian National Health Service. Extant literature has long emphasized the characteristics that auditing bodies are expected to possess in order to ensure audit quality. This paper offers an operationalization of such characteristics and discusses their peculiarities in a public-sector context. The relevant information was collected through an online questionnaire administered to the Boards of Statutory Auditors of all Italian public health-care organizations. The results show that the Boards’ characteristics are consistent with the literature’s suggestions and with the peculiarities of a public-sector setting. However, findings also underline some weaknesses in terms of both the adequacy of available resources and the relationship with other monitoring bodies and mechanisms.

Purpose: The paper aims to offer a viewpoint on how governmental budgeting needs to be reconsidered after the COVID-19 outbreak. Design/methodology/approach: Building on extant research, and drawing on the Italian context, the paper provides reflections on four interrelated aspects: (1) how budgeting and reporting processes and formats are being modified; (2) how budgeting may enhance governments' financial resilience; (3) how citizens are involved in the budgeting cycles and (4) how emergency responses may produce opportunities for corruption. Findings: To tackle COVID-19 related challenges, budgeting, rebudgeting, reporting processes and formats need to be reconsidered and supported by the development of new competencies. Governments will need to put stronger emphasis on the anticipatory and coping roles of budgeting to reduce public organizations' exposure to shocks and support governmental resilience. The involvement of citizens has proven critical to face the pandemic and will become increasingly relevant due to the financial impacts of COVID-19 on future public service provision. Greater attention to the risks of increased corruption is also needed. Originality/value: Drawing lessons from one of the countries most hit by COVID-19, the paper offers a viewpoint on a timely topic of international relevance by looking in an integrated way at interrelated topics such as budgeting, rebudgeting, reporting, financial resilience, coproduction and corruption.

Drawing on upper echelons theory, the article investigates the potential impact of top managers’ background and demographic characteristics and personality traits on organizational decisions in the public sector. The top-management figure being investigated is the municipal chief financial officer (CFO) and the specific organizational decision under analysis is the extent of revenue mis- representation during both budget formulation and execution. The empirical setting is provided by the CFOs of Italian municipalities with populations above 15,000 over a 3-year period (2012–14). Financial data are drawn from existing databases. Non-financial data are collected through an on- line survey.The results show that top managers’ individual characteristics and traits do influence the extent of accounting manipulation. In particular, revenue misrepresentation was found to be smaller in the presence of female managers, managers with degrees in business administration, and managers describing themselves as “conscientious”. These effects on accounting manipula- tion were moderated by auditors’ and opposition councilors’ oversight, managers’ experience, and the presence of local elections.The article extends upper echelons theory and its applications in several directions: from the private to the public context, from CEOs to CFOs, from managerial decisions in general to accounting choices, and from background and demographic variables to personality traits.

Purpose: The purpose of this paper is to examine how the convergence of private and public sector accounting standards is affecting conceptual and practical issues relating to heritage. More specifically, the paper is intended to provide a better understanding of the state of the art in national and international accounting standards on heritage assets, and of the views influencing such standards. Design/methodology/approach: A qualitative documentary analysis is carried out to explore the variety of existing positions and views on heritage, ranging from the scholarly literature, through potential stakeholders and users, to international and national standard setters. Findings: The analysis shows that the path of convergence between public and private sector standards and practices is still problematic. After more than two decades of debate around the nature, definition, measurement, and reporting of heritage, these issues are far from settled. Research limitations/implications: In the light of calls for increased measurement and reporting of public sector “assets”, and specifically for the definition of standards to recognise heritage, the paper suggests the need to strongly reconsider whether the convergence between public and private sector standards is desirable, feasible and effective. As such, the risks of embracing simplified or hybrid forms of accounting and reporting for heritage should be more seriously assessed. While reporting on heritage is important, it is fundamental to keep it distinct from reporting on government’s regular operations, in order to appreciate its specific value, nature and features. Originality/value: Looking at European national standards for heritage, the IPSASB’s proposals, and the reactions to the latter by relevant stakeholders, the paper provides a pluralistic view on the positions and experiences about heritage, contributing to the debate on the convergence between private and public sector accounting standards.

The impact of diagnosis-related group (DRG)-based funding has been analyzed along a wide range of dimensions. Its effects on hospital specialization, however, have been investigated only sparsely. This paper examines such effects in the context of the Italian National Health Service, where decentralization has produced a significant degree of variation in funding arrangements. To this end, a 9-year panel data set covering 762 Italian public and private hospitals was analyzed using a finite mixture model approach. Hospital specialization was measured by the internal Herfindahl-Hirschman Index. Three variables were introduced as proxies for the choices made by Italian Regions with respect to the development and use of their DRG systems. The best finite mixture model identified three groups of hospitals, two of which sizeable. Of these, one included nearly all public hospitals, while the other was composed almost exclusively of small and medium-sized investor-owned hospitals. Averagely, private and smaller hospitals showed a stronger tendency to specialize over time. The positive impact of DRG funding on the hospitals' propensity to specialize found only limited empirical support. Moreover, it emerged as comparatively much smaller for public hospitals vis à vis private ones.

Il capitolo presenta e analizza le performance economiche, finanziarie e patrimoniali delle aziende ospedaliere italiane nel periodo 2012-2015.

Traditional public administration (PA) relied on cash- or commitment-based budgets, while NPM advocated accruals accounting. Currently, Continental Europe is witnessing the re-emergence of the PA logic, but the relevant accounting implications have been insufficiently investigated. We focus on the Italian National Health Service. Our findings suggest that accruals accounting will not be repealed. However, accounting mutations will be introduced to increase consistency with the PA logic and budgetary accounting. Accruals accounting numbers will be interpreted and used accordingly. Great attention will be paid to nation-wide consolidated statements for the control of public finances, while faithful representation of individual organisations will be overshadowed.

Purpose – Budgeting is central in public organizations. From a research viewpoint, it is an extremely multifaceted and potentially rich field to investigate and develop. The changing institutional and socio-economic landscape, moreover, requires a profound reassessment of its roles and features in accounting studies. The purpose of this paper is to review the existing European literature on public budgeting, looking at how public administration, public management, and accounting contribute to current budgeting theories and practices and to advance a proposal on how they can individually and jointly contribute in the future. Design/methodology/approach – The authors collect and analyze all the papers on public budgeting in the European context that were published in all the issues of 15 major accounting and public-management journals since 1980. Findings – Budgeting has so far played a rather marginal role in European public management and accounting research. Among the existing papers, most focus on the Anglo-Saxon context, look at the intra-organizational aspects of budgeting, emphasize its managerial and allocative functions, either adopt an interpretive theoretical framework or make no explicit reference to theory, and rely on qualitative analyses. Public budgeting lies at the intersections between different disciplines and professions, but this multifacetedness has been largely neglected by the existing literature. These intersections thus offer significant opportunities for future research. Building on the distinction between the intra- and inter-organizational foci of budgeting, between its different functions (i.e. allocative, managerial, external accountability), and between the accounting and the public administration and management perspectives, the authors propose possible future research topics. Originality/value – Budgeting plays a central role in public organizations and is used to allocate a large share of national incomes. This paper explores the exi

The purpose of this paper is to analyse, in terms of presence, determinants and purposes, the misrepresentation of expected revenues during budget formulation and the misrepresentation of actual revenues during budget execution. To this end, we use six- year panel data from Italian municipalities with populations above 15,000. Our results suggest that overestimations of current revenues are more frequent than underestimations, during both budget formulation and budget execution. In terms of determinants, our results highlight the impact on revenue misrepresentation of both political orientation and fiscal stress. Finally, in terms of purposes, we show that revenue underestimation during budget formulation and revenue overestimation during budget execution may contribute to the formation of surpluses. The former, in particular, may allow mayors to create a ‘war chest’ in non-election years, which can then be used to increase net borrowing on the eve of elections.

INTRODUZIONE: Le aziende sanitarie nel corso dell’ultimo decennio sono state interessate da profondi processi di cambiamento nell’assetto organizzativo e istituzionale e sono stati sviluppati interventi di revisione profonda dei processi interni di funzionamento aziendale, quali implementazione di logiche di governo clinico, adozione di percorsi diagnostico-terapeutici assistenziali (PDTA), adozione di modelli per intensità di cura. In particolare, a vivere i cambiamenti più profondi, soprattutto in termini di assetti organizzativi, è stato l’ospedale che, negli ultimi anni, è stato sempre più interessato dall’adozione di modelli basati sull’intensità di cura che prevedono l’assunzione dei bisogni del paziente quali driver di riferimento su cui disegnare l’organizzazione ospedaliera, definire i PDTA, organizzare la logistica. Una trasformazione in tal senso implica necessariamente una sostanziale ridefinizione dell’organizzazione ospedaliera e pertanto dei relativi sistemi di programmazione controllo, da individuare a livello dei percorsi che caratterizzano le diverse aree di intensità di cura, piuttosto che a livello delle aree stesse o a livello di Unità Operative. Infatti, i cambiamenti nei modelli organizzativi e quelli nei sistemi di programmazione e controllo, alla luce del legame che unisce la struttura organizzativa e i meccanismi operativi, devono necessariamente andare di pari passo. Nell’ospedale per intensità di cure varia: - il sistema di budgeting, in quanto si modificano gli strumenti a supporto della definizione degli obiettivi e degli attori coinvolti (obiettivi di produzione e consumo vs obiettivi legati agli standard di percorso e processo); - il controllo dei fattori produttivi permanenti (PL, personale, tecnologie, etc.), che viene attribuito alle nuove aree di intensità di cura; - l’articolazione delle responsabilità produttive ed economiche, che è individuata a livello di percorso. L’obiettivo dello studio è quello di effettuare u

INTRODUZIONE: Le aziende sanitarie nel corso dell’ultimo decennio sono state interessate da profondi processi di cambiamento nell’assetto organizzativo e istituzionale e sono stati sviluppati interventi di revisione profonda dei processi interni di funzionamento aziendale, quali implementazione di logiche di governo clinico, adozione di percorsi diagnostico-terapeutici assistenziali (PDTA), adozione di modelli per intensità di cura. In particolare, a vivere i cambiamenti più profondi, soprattutto in termini di assetti organizzativi, è stato l’ospedale che, negli ultimi anni, è stato sempre più interessato dall’adozione di modelli basati sull’intensità di cura che prevedono l’assunzione dei bisogni del paziente quali driver di riferimento su cui disegnare l’organizzazione ospedaliera, definire i PDTA, organizzare la logistica. Una trasformazione in tal senso implica necessariamente una sostanziale ridefinizione dell’organizzazione ospedaliera e pertanto dei relativi sistemi di programmazione controllo, da individuare a livello dei percorsi che caratterizzano le diverse aree di intensità di cura, piuttosto che a livello delle aree stesse o a livello di Unità Operative. Infatti, i cambiamenti nei modelli organizzativi e quelli nei sistemi di programmazione e controllo, alla luce del legame che unisce la struttura organizzativa e i meccanismi operativi, devono necessariamente andare di pari passo. Nell’ospedale per intensità di cure varia: - il sistema di budgeting, in quanto si modificano gli strumenti a supporto della definizione degli obiettivi e degli attori coinvolti (obiettivi di produzione e consumo vs obiettivi legati agli standard di percorso e processo); - il controllo dei fattori produttivi permanenti (PL, personale, tecnologie, etc.), che viene attribuito alle nuove aree di intensità di cura; - l’articolazione delle responsabilità produttive ed economiche, che è individuata a livello di percorso. L’obiettivo dello studio è quello di effettuare una revisione

Reforms of the public health-care sector have emphasised the role of management accounting (MA). However, there is little systematic evidence on its use and benefits. To fill this gap, we propose a contingency-based model which addresses three related issues, that is, whether: (i) MA use is influenced by contextual variables and MA design; (ii) top-management satisfaction with MA mediates the relationship between MA design and MA use; and (iii) financial performance is influenced by MA use. A questionnaire was mailed out to all Italian public health-care organisations. Structural equation modelling was performed to validate the research hypotheses. The response rate was 49%. Our findings suggest that: (i) cost-containment strategies encourage more sophisticated MA designs; (ii) MA use is directly and indirectly influenced by contingency, organisational, and behavioural variables; (iii) a weakly significant positive relationship exists between MA use and financial performance. These findings are relevant from the viewpoint of both top managers and policymakers. The former must make sure that MA is not only technically advanced, but also properly understood and appreciated by users. The latter need to be aware that MA may improve performance in ways and along dimensions that may not fully translate into better financial results.