Reforms and accounting system changes: A study on the implementation of accrual accounting in Norwegian hospitals

The purpose of this paper is to provide insights into the process of the accounting system change as a part of a larger reform initiative taking place in Norway. The research context is the national network of hospital enterprises.

The paper uses an archival‐based case approach of official documents (between 2000 and 2009) to study the formal layers of accounting practices.

The accrual accounting information signalled major management control problems, but the hospital owner, the state, did not take action to solve these problems during this period. The contracts between the state and hospital enterprises were characterised as principal‐agent relationships. However, different accounting techniques were mixed in the contracts between the parties, indicating hybridisation of accounting systems.

The authors did not study the perceptions and practices of key actors and this is a limitation of the study.

The findings are likely to be useful for practitioners and researchers to gain knowledge on the implementation of management reforms in public sector service organisations.

This paper contributes to our understanding of the diverse processes within which public sector reforms are taking place. The main contribution is a discussion of the diversity in accounting system changes.