Identifying the Effective Factors for Auditing the Performance of Executive Managers of Public Hospitals: A Qualitative Study

Abstract

Background: According to the characteristics of public hospitals, a review of the flexibility of the components of their management accounting system is necessary. Objectives: The present study aimed to identify the factors affecting the audit of the performance of executive managers of public hospitals. Methods: The present study is an applied qualitative study based on grounded theory. In this regard, semi-structured interviews were conducted using the expert sampling technique and interviewing 18 specialists and experts familiar with the financial affairs of public hospitals. The sample size for interviewing experts was finalized within the theoretical saturation framework. The data analysis was performed in 3 stages of grounded theory, including open coding, axial coding, and selective coding. Then, the effective factors were classified into 6 main categories: causal conditions, axial phenomena, contextual factors, intervening conditions, strategies, and consequences in the form of a paradigm model. Results: “The field of auditing, the field of organizational management, and the field of the structure” were 3 categories related to causal conditions. “Budgeting and financial reporting” were identified as 2 main phenomena factors affecting the audit performance of executive managers of public hospitals; also, “establishment conditions, techniques, and requirements for auditing” were recognized as contextual conditions. “Environmental factors, applicable laws, and regulations” were identified as mediating/intervening conditions. Strategic conditions included “structural factors and behavioral factors at the level of medical universities”; also, the categories of “public sector productivity, economic efficiency, effectiveness, efficiency, and achievement of organizations” were recognized as outcomes related to auditing the performance of executive managers of public hospitals. Conclusions: Recognizing the factors affecting the performance audit of public hospital managers is extremely significant and should be designed based on its affecting components, a standard and integrated auditing system for auditing the performance of public hospital managers.