Accountingization, trust and medical dilemmas

The purpose of this paper is to investigate the impact of accounting on clinical practices.

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.

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.

The paper shows that the combination of accounting and medical data in a topical matter makes this an original and distinctive study.