Financial Sustainability of Higher Education Institutions: A Challenge for the Accounting System

The chapter analyses pitfalls and opportunities for accrual and cost accounting to play a role in fostering universities\u2019 financial sustainability. Some aspects of the Italian context are analyzed more in depth, although accrual-based accounting and budgeting as well as cost accounting systems have spread in the HEIs of many countries. Both practices aim at improving universities\u2019 capability to cover their full costs, thus supporting transparency and financial sustainability. Despite the expected advantages of accrual accounting, empirical evidences still lack: rather, in some countries the reform of accounting system in HE had no effect. This paper investigates possible causes of this discrepancy. After having displayed the role of accrual accounting in supporting universities\u2019 financial sustainability, some obstacles are evidenced that reduce the transparency or the usefulness of accounting information and weaken its capability to support financial sustainability. Some issues suggest caution in the interpretation of universities\u2019 financial performance.: in particular, doubts arise considering the accounting treatment of transfers from the government that are still the main source of universities\u2019 revenues in most countries. The paper shows that also organizational issues may deprive accrual accounting of its capability to provide reliable, transparent and complete information. Moreover, the adoption of cost accounting practices risks to remain symbolic or ceremonial, i.e. functional to the enhancement of the organization\u2019s appearance of rationality and efficiency unless corrective factors are introduced

Public Italian universities towards accrual accounting and management control

The paper analyzes the accounting, financial reporting and management control systems of the Italian public universities, according to the new legislation (Law 240/2010, Decree 18/2012). This reform includes two important changes: the adoption of accrual accounting and the introduction of a management control system, both mandatory from 1st January 2014. The paper provides a description of the current situation of Italian universities, which allows to understand the reality in which the reform will be implemented and to evaluate whether universities are ready to realize these important changes. For this purpose, an empirical analysis has been conducted, based on the results of a semi-structured questionnaire that was applied to the 67 public universities during the first half of 2013. Survey results indicate that not many universities possess budgeting and accounting reporting systems aligned with the new legislation; however, most of them have executed different types of efforts for the transition process

Sequence variants at the TERT-CLPTM1L locus associate with many cancer types

The common sequence variants that have recently been associated with cancer risk are particular to a single cancer type or at most two. Following up on our genome-wide scan of basal cell carcinoma, we found that rs401681[C] on chromosome 5p15.33 satisfied our threshold for genome-wide significance (OR = 1.25, P = 3.7 x 10(-12)). We tested rs401681 for association with 16 additional cancer types in over 30,000 cancer cases and 45,000 controls and found association with lung cancer (OR = 1.15, P = 7.2 x 10(-8)) and urinary bladder, prostate and cervix cancer (ORs = 1.07-1.31, all P < 4 x 10(-4)). However, rs401681[C] seems to confer protection against cutaneous melanoma (OR = 0.88, P = 8.0 x 10(-4)). Notably, most of these cancer types have a strong environmental component to their risk. Investigation of the region led us to rs2736098[A], which showed stronger association with some cancer types. However, neither variant could fully account for the association of the other. rs2736098 corresponds to A305A in the telomerase reverse transcriptase (TERT) protein and rs401681 is in an intron of the CLPTM1L gene

Mortality after surgery in Europe: a 7 day cohort study

Background: Clinical outcomes after major surgery are poorly described at the national level. Evidence of heterogeneity between hospitals and health-care systems suggests potential to improve care for patients but this potential remains unconfirmed. The European Surgical Outcomes Study was an international study designed to assess outcomes after non-cardiac surgery in Europe.Methods: We did this 7 day cohort study between April 4 and April 11, 2011. We collected data describing consecutive patients aged 16 years and older undergoing inpatient non-cardiac surgery in 498 hospitals across 28 European nations. Patients were followed up for a maximum of 60 days. The primary endpoint was in-hospital mortality. Secondary outcome measures were duration of hospital stay and admission to critical care. We used χ² and Fisher’s exact tests to compare categorical variables and the t test or the Mann-Whitney U test to compare continuous variables. Significance was set at p&lt;0·05. We constructed multilevel logistic regression models to adjust for the differences in mortality rates between countries.Findings: We included 46 539 patients, of whom 1855 (4%) died before hospital discharge. 3599 (8%) patients were admitted to critical care after surgery with a median length of stay of 1·2 days (IQR 0·9–3·6). 1358 (73%) patients who died were not admitted to critical care at any stage after surgery. Crude mortality rates varied widely between countries (from 1·2% [95% CI 0·0–3·0] for Iceland to 21·5% [16·9–26·2] for Latvia). After adjustment for confounding variables, important differences remained between countries when compared with the UK, the country with the largest dataset (OR range from 0·44 [95% CI 0·19 1·05; p=0·06] for Finland to 6·92 [2·37–20·27; p=0·0004] for Poland).Interpretation: The mortality rate for patients undergoing inpatient non-cardiac surgery was higher than anticipated. Variations in mortality between countries suggest the need for national and international strategies to improve care for this group of patients.Funding: European Society of Intensive Care Medicine, European Society of Anaesthesiology