This doctoral research focuses on the application of management accounting and control systems (MACS) in nursing homes, care homes and home care sectors. How are these kinds of systems applied in these sectors? What characteristics do they have? Where and why do these systems work well, and when do they not?
New legislation for these sectors has led to the introduction of market forces. The idea behind this is that a more commercial, market-oriented approach will improve the effectiveness of care. At the same time, we see that organizations in these sectors are having to deal with more outspoken clients who are demanding more individualized care. The cohort known as the ‘grateful generation’ is slowly passing away and giving way to a generation of more critical care consumers, who are often paying for a part of their care of their own pockets. All of this means that the organizations active in this sector are increasingly exposed to market risks. The managers of these companies are increasingly having to profile themselves as ‘care entrepreneurs’. As a result of these developments, managers in the care sector are making increasing use of MACS in order to identify business risks in time to take action, and to improve the efficiency of care. This intensive use of MACS is not limited to senior management. Lower-level management, such as team leaders who supervise nursing and care staff in the immediate proximity of clients, are also coming into increasing contact with MACS. Precisely because these team leaders are close to daily practice, they are viewed as being better able to come up with solutions to clients’ problems. In order to do this, they are also being delegated more responsibilities by those in more senior positions, such as budget responsibilities. They also need MACS in order to manage these finances correctly and account for their responsibilities properly.
The aim of this study is to give an outline of the application of MACS in the care sector. How should MACS be designed in order to meet the new challenges facing the care sector? And conversely, how is the introduction of MACS affecting the practice of care? How do managers handle MACS data and what effect is this having? Three in-depth case studies are being carried out as part of this research. The aim is ultimately to derive a set of lessons for the management of care organizations in relation to the introduction and use of MACS.