In order to cope with the explosion of medical expenditure and improve performance, several countries of the EU are currently introducing or reinforcing the use of medico-economic key figures in hospitals on the basis of Diagnosis-Related Groups (DRG)-systems. But this introduction has led to varying results.While some studies point out its influence on working practices and clinical procedures, other studies demonstrate that key figures are used decoupled from medical activities and there is no effect on economic performance or cost-effectiveness. The present research argues current paradigms in management accounting do not sufficiently explain the above-described situations.As more and more countries are currently introducing similar key figure systems o r are already using them, it is essential for European countries to clarify these questions and gain valuable insight on theoretical frameworks, concrete managerial implications and transferability of experience.The researcher analysed in her PhD the introduction of key figures based on the DRG-system in a French hospital between 2001 and 2005. It concluded that medico-economic key figures could become actual tools for agents to reorganise care activity and improve economic performance.As the UK is now introducing a similar system, the present research proposes to deepen the knowledge of the use of key figures by transferring knowledge and skills gained in France to the British context, by resuming some open question of the previous PhD research and comparing results of the two cases. To this end, several cases studies on the use of managerial key figures are carried out in UK based hospitals.From a theoretical viewpoint one of the objectives of the present research is to contribute to the definition of an alternative theoretical framework for the use of management tools. From a practical viewpoint this research has the objective to point out managerial implications for the introduction of key figures.
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