The relation between cost-system design, managers’ evaluations of the relevance and usefulness of cost data, and financial performance: an empirical study of US hospitals

This study examines the association between cost-system functionality, managers’ beliefs about the relevance and usefulness of cost data, and actual financial performance using a sample of 277 US hospitals. Results indicate that managers’ evaluations of the relevance and usefulness of cost data are positively correlated with the extent to which systems can provide greater cost detail, better classify costs according to behavior, and report cost information more frequently. However, only the ability to supply cost detail is favorably associated with measures of financial performance, including operating margin, cash flow, and administrative expense. Interestingly, cost-system design was not associated with operating expense per admission, suggesting that accounting information had not yet been successfully used to manage clinical costs.