A nonparametric analysis of the Greek renewable energy sector

This paper applies a bootstrapped Data Envelopment Analysis (DEA) formulation aiming to evaluate the financial performance of the firms operating in the Greek renewable energy sector. With the use of financial ratios in a DEA setting, efficiency ratios are constructed in order to analyse firms’ financial performance. The results reveal that firms’ performances are positively influenced by the high levels of return on assets and equity and by lower levels of debt to equity. In addition it appears that there are not significant differences of firms’ efficiency levels indicating high competitiveness between firms. Finally, firms producing wind energy appear to perform better than firms producing hydropower energy. It emerges that the majority of firms are operating in the wind and hydropower energy production making the Greek market of solar energy production being an emerging segment of the Greek renewable energy sector.Renewable energy market; Data Envelopment Analysis; Financial ratios; Greece

Evolution of the Governmental Accounting Reform implementation in Greek Public Hospitals: Testing the institutional framework

Purpose – In an attempt to promote efficiency, effectiveness and economy in health service production, the Greek government imposed in 2003 an accrual basis financial and cost accounting system in all public hospitals of the National Health System (NHS). The purpose of this study is not to investigate thoroughly the accounting reform implementation and adoption in specific organizations, but rather to obtain an overall idea of the reform adoption process in Greek public hospitals by identifying major areas of non-compliance with the mandatory legislative accounting framework and various organisational contingencies that influence the level of reform adoption within a broad institutional framework. Design/methodology/approach – Our analysis is based on the results of an empirical survey that took place during 2009. For the purposes of this survey, a compliance index is constructed and applied on a sample of 94 Greek public hospitals using a structured questionnaire and semi-structured interviews with six public hospital Financial and Accounting executives. Findings – The empirical evidence reveals that the level of accrual basis financial and especially cost accounting adoption in Greek public hospitals is realized only to a limited extent. In particular, results show that the relationship between the institutional isomorphic pressures and accounting reform implementation process is restricted by organizational capability factors (i.e., the quality of existing Information Technology systems, the education level of finance and accounting staff, the extent of reform related training, and the professional support of consultants). Research limitations/implications – Although this study takes into consideration the work of previous researchers in the health care area, it acknowledges that empirical research on the subject in the Greek environment is limited. Therefore this study should be viewed as an initial step to address this limitation. Originality/value – This study draws on the information systems change, management accounting innovation, and public sector reform literatures to contribute to the current knowledge in public sector accounting by examining a number of factors that are expected to influence the implementation and adoption process of accrual and cost accounting practises in the Greek public healthcare sector within a broad institutional framework. Contribution - This study contributes to the international literature of New Public Management (NPM) initiatives in public health sector by providing, to our knowledge, the first large cross-sectional assessment of accrual accounting reform adoption and implementation in Greek public hospitals. Additionally, the empirical evidence of this study can enhance researchers’ and managers’ understanding of major implementation processes and challenges and thus help them refine models of effective implementation process and improve systems and processes on similar future projects.Accrual Accounting, Public Sector Accounting, Compliance Index, Public Hospitals, Isomorphism.

Assessing Accrual Accounting Reform in Greek Public Hospitals: An Empirical Investigation

During the last decades, several countries worldwide have introduced financial management reforms, as an important part of the New Public Management (NPM) initiative at one or more levels of government sector, by either replacing or transforming their traditional budgetary cash accounting systems towards a business-like accrual accounting concept. Following the example of this upcoming managerial trend, the Greek government introduced in 2003 the accrual basis accounting into public hospitals, as the hospital sector is one of the areas where NPM reforms have been introduced in search of higher efficiency, effectiveness and economy in service production. The purpose of this paper is twofold. The first goal is to provide an overview of the government sector reform initiatives in Greece and to present empirical evidence regarding the adoption level of the accrual basis accounting standards in the Greek public Health sector. The second goal of the research is to investigate the impact of a range of potentially contingent factors on hospitals compliance with the accrual financial and cost accounting reform. The present analysis is based on the results of an empirical survey that took place during 2009. For the purposes of this survey, a structured questionnaire was prepared and sent to the Chief Financial Officers (CFOs) of 132 Greek public hospitals. In particular, a linear regression model analysis was used to examine the cross-sectional differences on a number of explanatory and implementation factors of the accounting reform adoption level. The empirical evidence reveals that the level of accrual and especially cost accounting adoption in Greek public hospitals is realized only to a limited extent. In particular, results show that the level of reform adoption is positively related to IT quality, reform related training, education level of accounting staff, and professional consultants’ support. However, no significant relationship was found between the level of reform adoption and hospital size, reform implementation cost, CEO educational background, experience effect, and absence of management-physicians conflict relationship. The main contribution of this study is the empirical evidence it provides on the approaches and processes used by the Government of Greece to implement accrual financial and cost accounting systems in the Greek National Health System (GNHS) and the role certain human, organizational and situational factors played in such implementations for enhancing researchers’ and managers’ understanding of major implementation processes and challenges as well as helping them refine models of effective implementation process and improve systems and processes on similar future projectsAccrual Accounting, Public Sector Accounting, Compliance, Public Hospitals, contingency factors

Measuring across hospital efficiency and productivity : the case of second regional health authority of Attica

The purpose of the study is to investigate technical efficiency and productivity change of a sample of Greek Hospitals over the period 1998 - 2005. Efficiency and productivity measurement became a crucial issue in Greece after the launching of health reforms in 2001, with the legislative Act No. 2889, aiming at cost containment and improvements in hospital efficiency. Applying the linear programming method of Data Envelopment Analysis we investigate how efficiently the hospital resources are used to obtain the maximum possible outcome, before and after the reforms. Hospital output is modelled in terms of interventions, laboratory examinations, outpatient and inpatient cases. Inputs considered include beds, doctors, nurses and rest personnel and operational expenses. The analysis indicates that the reforms have generated efficiency gains when only input and output quantities are considered. During the period 1998- 2002 an overall efficiency regress is observed followed by an upturn, after the launching of managerial reforms. However, when the running costs of the hospitals are considered, then the sample experiences significant regress, implying relatively higher production costs over time. We conclude that DEA is a useful technique to assess relative efficiency and optimum hospital performance across hospitals.peer-reviewe

"A manager in the minds of doctors" : a comparison of new modes of control in European hospitals

Background: Hospital governance increasingly combines management and professional self-governance. This article maps the new emergent modes of control in a comparative perspective and aims to better understand the relationship between medicine and management as hybrid and context-dependent. Theoretically, we critically review approaches into the managerialism-professionalism relationship; methodologically, we expand cross-country comparison towards the meso-level of organisations; and empirically, the focus is on processes and actors in a range of European hospitals. Methods: The research is explorative and was carried out as part of the FP7 COST action IS0903 Medicine and Management, Working Group 2. Comprising seven European countries, the focus is on doctors and public hospitals. We use a comparative case study design that primarily draws on expert information and document analysis as well as other secondary sources. Results: The findings reveal that managerial control is not simply an external force but increasingly integrated in medical professionalism. These processes of change are relevant in all countries but shaped by organisational settings, and therefore create different patterns of control: (1) ‘integrated’ control with high levels of coordination and coherent patterns for cost and quality controls; (2) ‘partly integrated’ control with diversity of coordination on hospital and department level and between cost and quality controls; and (3) ‘fragmented’ control with limited coordination and gaps between quality control more strongly dominated by medicine, and cost control by management. Conclusions: Our comparison highlights how organisations matter and brings the crucial relevance of ‘coordination’ of medicine and management across the levels (hospital/department) and the substance (cost/quality-safety) of control into perspective. Consequently, coordination may serve as a taxonomy of emergent modes of control, thus bringing new directions for cost-efficient and quality-effective hospital governance into perspective

Investigating the Governmental Accounting Reform of Greek National Health System (ESY): Some preliminary Evidence

During the last decades, several countries worldwide have introduced financial management reforms as an important part of the New Public Management (NPM) initiative at one or more levels of government sector, by replacing or transforming their traditional budgetary cash accounting systems towards business-like accrual accounting. Following the example of this upcoming managerial trend, the Greek government introduced in 1997 an accrual based accounting system (ABAS) and double-entry book-keeping method in all public hospitals. The hospital sector is one of the areas where NPM reforms have been introduced in search of higher efficiency in service production. The purpose of this paper is twofold. Our first goal is to provide an overview of the government sector reform initiatives in Greece and to present evidence regarding the adoption rate of the new accounting system by the Greek public health sector. The second goal of our research is to present the perceived usefulness of the accounting information provided by the proposed accounting reform as well as the implementation problems encountered in implementing ABAS. Our analysis is based on the results of an empirical survey that took place during 2008. For the purposes of this survey, a structured questionnaire was prepared and sent to the Finance Directors of 132 Greek public hospitals.Accrual Accounting, Public Sector Accounting, Public Hospitals, New Public Management.

Data envelopment analysis (DEA) and financial ratios : a pro-stakeholders’ view of performance measurement for sustainable value creation of the wind energy

Purpose: The purpose of the paper is to explore business performance in a rather sensitive sector that equally combines economic, environmental and social dimensions. The paper investigates the efficiency of wind farm companies, in a framework of pursuing more diverse stakeholders’ interests Design/Methodology/Approach: Ratios and DEA approaches are combined to measure economic efficiency among the DMUs of a sample of wind farms, using data from their financial statements. Findings: Productivity and effectiveness comprise the performance measured by the economic efficiency. We show that by choosing inputs and outputs that are closely related in forming an appropriate financial ratio, it helps to design and explain more fully the impact of a policy intervention aiming at improving economic efficiency. DEA supplements ratios to design, implement and assess a strategy of benchmarking towards bolstering performance, that favors a wider range of stakeholders. Originality/Value: The study provides an in-depth insight into using Data Envelopment Analysis and financial ratios to study economic efficiency. The approach combines economic, social and environmental dimensions (indirectly) of performance, and the composite ratio Return on Total Assets (ROTA). The analysis caters the specific features of the sector renewable energy and their diverse stakeholders.peer-reviewe

Tomorrow’s public hospital in Greece: Managing health care in the post crisis era

Η νοσοκομειακή διοίκηση (οριζόμενη ως ηπροσπάθεια για την βέλτιστη απόδοση μέσωκατάλληλων κύκλων σχεδιασμού, αποφάσεων, αξιολόγησης και επανελέγχου) τέμνει όλεςτις λειτουργικές παραμέτρους παραγωγής καιπροσφοράς υπηρεσιών υγείας. Το δημόσιοΕλληνικό νοσοκομείο του αύριο θα πρέπει νααπαντήσει στις τέσσερις προβληματικές ενότητες του σημερινού συστήματος: τον ιατρικόυποκειμενισμό, το απαρχαιωμένο μοντέλο διοίκησης, την έλλειψη εργαλείων διαχείρισηςανθρώπινου δυναμικού και την προβληματικήχρηματοδότηση των ελληνικών νοσοκομείων.Το νοσοκομείο του αύριο θα πρέπει να σέβεται την αυτονομία του ιατρικού επαγγέλματοςενώ ταυτόχρονα να απαιτεί επιστημονική λογοδοσία, θα πρέπει να χρησιμοποιεί μοντέρναεργαλεία επιχειρησιακής οργάνωσης ώστε ναδιαχειριστεί το ανθρώπινο δυναμικό του μεαπώτερο στόχο την αποδοτική και αποτελεσμα-τική παραγωγή υπηρεσιών υγείας και τέλος θαπρέπει να μετράει την απόδοση του σε κάθεπεριστατικό. Σε αυτή την κατεύθυνση θα κατευθυνθούν τα νοσοκομεία τα επόμενα χρόνια.The management of the hospitals (definedas the attempt for optimum performancevia appropriate cycles of planning, deciding,evaluating, and reviewing), transcends allthe functional parameters of the productionand provision of health services. Tomorrow’spublic hospital in Greece demands anew managerial approach. This approachwould sufficiently answer to the main fourproblematic conundrum of today: the perverseunaccountability of medical subjectivity, theobsolete management model, the lack ofhuman resources management tools and theunhealthy financing of hospitals. Tomorrow’shospital would respect the autonomy of themedical profession while at the same timewould demand scientific accountability,would utilize modern organizational toolsto manage its human resources in order toproduce effectively and efficiently qualityservices and finally would measure itsperformance on a case by case basis