dc.description.abstract | The
demand
for
public
healthcare
services
has
increased
rapidly
over
the
last
decades,
which
has
entailed
an
amplified
pressure
on
the
healthcare
organizations
to
increase
the
efficiency
of
care.
In
the
1980s,
a
wave
of
change
usually
referred
to
as
New
Public
Management
swept
over
the
public
sector
and
a
number
of
private
sector
management
techniques
were
implemented,
including
the
concept
of
performance
management.
The
traditional
concept
of
financial
performance
measurement
clashed
against
the
intricate
notions
of
good
care,
subsequently
leading
to
the
introduction
of
new
performance
measurement
tools
that
included
non-‐financial
performance
measures.
However,
these
tools
were
also
adopted
from
the
private
sector
and
not
tailored
for
the
decentralized
healthcare
organizations
with
its
many
stakeholders
and
individuals
of
different
professions.
The
decentralized
healthcare
organization
is
subject
to
the
control
complexities
of
action
at
a
distance,
where
operating
personnel
might
have
difficulties
in
interpreting,
understanding
or
personally
rationalize
the
inscriptions
inherent
in
specific
accounting
techniques
supporting
certain
programs
or
objectives.
Within
public
mental
healthcare,
the
issues
of
performance
measurement
are
even
further
enhanced
due
to
the
absence
of
objective
outcome
indicators,
making
the
different
users’
interpretations
of
performance
measurement
imperative
to
its
result.
Although
there
is
substantial
literature
on
the
topic
of
management
accounting
within
public
healthcare
in
general
and
public
mental
healthcare
in
specific,
there
is
a
gap
in
the
research
of
the
interpretations
and
perceptions
on
account
of
the
actors
at
different
hierarchical
levels
within
healthcare
organizations
regarding
the
purposes
of
given
performance
measures.
Hence,
in
order
to
aid
the
further
development
of
performance
measurement
within
public
mental
healthcare,
this
study
focuses
on
the
role
assigned
to
given
performance
measures
by
personnel
at
different
hierarchical
levels
within
a
public
mental
healthcare
organization,
the
reasons
therefore
and
the
consequences
thereof.
A
qualitative
case
study
conducted
within
the
region
of
Västra
Götaland,
Sweden,
illuminates
the
meaning
of
hierarchical
communication,
role
perceptions,
sense-‐giving,
accountability,
stakeholder
perspective,
and
cooperation
in
developing
performance
measures
as
shaping
the
perceptions
of
performance
measures
at
different
hierarchical
levels. | sv |