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An Institutional Theory Perspective On The Drg Framework, Case-Mix Accounting Systems And Health-Care Organizations, Mark A. Covaleski, Mark W. Dirsmith, Jeffrey E. Michelman

Jeffrey E Michelman

Case-mix accounting systems have been advanced as both reflecting the economic reality that underlies a hospital's various “product lines”, as defined by DRG prospective payment categories, and facilitating rational decision making regarding resource acquisition, deployment and use. This article uses the institutional perspective to extend this conceptualization of case-mix accounting systems. The institutional perspective proposes that many elements of organizational structure, like case-mix accounting systems, reflect as much a need to conform to societal expectations of acceptable practice as the technical imperative of fostering rationality. This article also extends institutional theory regarding the issues of power and decoupling by considering …