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The purpose of this article is to contribute to the ongoing debate on the internal audit function in the public sector, by discussing the role that this function can play in addressing the following issues: (i) the complex and fragmented structure of internal control systems resulting from the progressive layering of multiple audit bodies and assurance providers with different standards and tools, and possible overlapping competences and activities, and (ii) the emphasis of internal controls on monitoring, which has become an end in itself, with no attention to value creation. To this end, the article examines the evidence from a research project aimed at improving the internal control system of public healthcare organizations in an Italian region (i.e., Emilia-Romagna) that has long since reflected on public audit issues. Findings shed light on the activities and tools developed and implemented by the regional audit team and the internal auditors. The article provides some significant research contribution in that, drawing on the theoretical lens provided by Miller and Power, it reveals how the internal audit function can improve integration and coordination within the internal control system and foster a risk management culture that enables organizational learning.

The fight against corruption has become a priority for both international organizations and national governments worldwide. To fight corruption, several strategies have been suggested which enlist accounting because of its natural orientation towards information disclosure, integrity systems, and efficiency. This article presents a comprehensive literature review regarding accounting vis-à-vis corruption in the public sector. The review combines a bibliometric and a qualitative analysis. The findings reveal a highly fragmented field of research, with no consolidated networks of scholars. The conceptual structure of the field consists of five main themes, corresponding to different strategies through which accounting can contribute towards fighting corruption. Accounting assemblages, however, may not fulfil expectations and were found to play a wide spectrum of roles, ranging from an effective prevention of corruption to active complicity with it. These roles are affected by individual, organizational, and external variables. The article concludes by outlining several avenues for future research.

Lo studio analizza le scelte e le pratiche aziendali relative all’introduzione e allo sviluppo della funzione di Internal Audit nel settore pubblico, considerando il caso particolarmente emblematico del Servizio Sanitario Nazionale. I dati sono stati raccolti mediante la somministrazione online di un questionario. Lo studio analizza: il profilo professionale del responsabile dell’Internal Audit; l’assetto organizzativo della funzione; il ruolo e gli ambiti di attività; il rapporto con la Regione, la Direzione Aziendale e gli altri organi di controllo; le modalità di lavoro; le aree di miglioramento. I risultati mostrano un quadro piuttosto variegato. Le conclusioni dello studio offrono una sistematizzazione sia dei principali punti di forza sia degli aspetti che necessitano invece di essere potenziati., The study maps the introduction and development of Internal Auditing in the Italian National Health Service. Data were collected through an online questionnaire. The study investigates the following topics: the professional profiles of internal auditors; the organizational configurations of the Internal Audit function; the roles and activities performed by the Internal Audit unit; the relationships with the Regional government, the health-care organization’s own top management, and the other control bodies; the auditing methodologies employed; and the main areas for improvement. Results show a mixed picture. The conclusions offer a systematization of the Internal Audit function’s strengths and weaknesses.

Il presente studio intende offrire un contributo al dibattito sulla Gestione Sanitaria Accentrata (GSA). Nello specifico, propone uno strumento innovativo, vale a dire la redazione di un sistema di procedure amministrativo-contabili della GSA che, travalicando i confini organizzativi della GSA stessa e abbracciando una logica integrata di sistema del SSR, mappa i flussi di risorse afferenti al fabbisogno sanitario. Attraverso la disamina di due casi studio particolarmente emblematici (quello della GSA in Lombardia e quello di Azienda Zero in Veneto), lo studio mostra che le procedure sistemiche e integrate della GSA (i) sono utilmente applicabili in contesti diversi, in quanto in grado di coglierne e valorizzarne le peculiarità organizzative e contabili; (ii) costituiscono un valido strumento di risposta alle principali problematiche della GSA soprattutto in termini di governo e controllo della filiera Regione-GSA-aziende sanitarie.

This article responds to the need for greater theorization in public auditing research. The authors report on a study that investigated the introduction and development of internal auditing (IA) in public sector organizations by combining new institutional sociology and old institutional economics. The study compared three cases in the Italian National Health Service (INHS). Results demonstrate that institutional pressures do not generate the same responses across the cases. The power and interests of different actors (and their interactions) are crucial for IA legitimation and sense-making.

Il presente studio analizza la funzione di Internal Audit e in particolare approfondisce come essa possa: (i) migliorare i processi aziendali attraverso lo sviluppo di azioni di miglioramento; (ii) generare valore rispetto ai controlli di primo e secondo livello; (iii) garantire il corretto funzionamento del Sistema di Controllo Interno. A tal fine, viene presentata una tra le esperienze più consolidate nel panorama nazionale, vale a dire il caso della Regione Veneto. Lo studio presenta l’applicazione degli strumenti e dei metodi dell’audit interno al processo delle prestazioni specialistiche erogate in regime di Libera Professione. I risultati mettono in evidenza il valore aggiunto apportato dalla funzione di Internal Audit. Lo studio identifica, inoltre, le opportunità e potenziali criticità riscontrabili nello svolgimento di un audit interno.

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.

Negli ultimi anni, in particolare a seguito del percorso attuativo della certificabilità, gli enti e le aziende del Servizio Sanitario Nazionale hanno prestato crescente attenzione al disegno, all’implementazione e all’affinamento del proprio Sistema di Controllo Interno. La diffusione di una cultura del controllo sia esterno sia interno ha portato in diversi casi all’istituzione di un servizio di Internal Auditing (di seguito IA) come garante di tale sistema di controlli. Il presente contributo approfondisce le modalità attuative della funzione di IA negli enti e nelle aziende del Servizio Sanitario Nazionale attraverso un’analisi di casi studio delle esperienze regionali che per prime si sono mosse in questa direzione e che risultano più significative, Regione Veneto e Regione Emilia-Romagna. Di ciascuna sono esaminate e poi raffrontate le principali variabili della funzione di IA approfondite dalla dottrina e precisamente: i ruoli, le tipologie e i processi di audit, le variabili organizzative e le caratteristiche delle risorse umane impiegate nella funzione. Ne emergono due modalità attuative tra loro distinte che, seppur condizionate dai rispettivi contesti di riferimento, contengono anche interessanti punti di contatto e significativi spunti di riflessione per le altre Regioni che si stanno avviando nel percorso di implementazione della funzione di IA.

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.

This study investigates the conditions under which transparency contributes to citizens' understanding of financial reporting and examines how this enhanced understanding is associated with public participation. To this end, a survey experiment was conducted in which two attributes of financial reporting transparency (i.e., content clarification and presentation format) were the manipulated variables, whereas citizens' understanding and public participation were the outcome variables. Results demonstrate that the provision of explanations to clarify obscure technical jargon does have a positive effect on citizens' understanding. A similar effect was found for the provision of graphical and visual representations. However, the study reveals that there is no additional benefit in simultaneously providing both explanations of technical jargon and visual aids. Furthermore, findings show that the levels of public participation are highest among the individuals who felt they understood the financial information the best, but yet possessed the lowest level of actual understanding.

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.