The Effectiveness of Accrual Accounting on Optimal Financial Decision-Making of Healthcare Managers in Determining Medical Service Costs
Keywords:
accrual accounting, financial transparency, managers' decision-making, performance-based budgeting, service costingAbstract
This study aimed to evaluate the effectiveness of accrual accounting and accrual-based reporting in improving healthcare managers’ financial decision-making in determining the full cost of medical and educational services. This study adopted a mixed-methods design combining qualitative and quantitative approaches. In the qualitative phase, content analysis was employed to identify key accrual accounting indicators from relevant literature. In the quantitative phase, a descriptive-survey design was implemented using a researcher-developed questionnaire. The statistical population consisted of financial managers, accountants, and auditors from universities of medical sciences in Sistan and Baluchestan province, from which 118 participants were selected using simple random sampling based on the Morgan table. The questionnaire included 117 items across five dimensions. Content validity was confirmed by experts, and reliability was established using Cronbach’s alpha (0.85). Data were analyzed using SPSS software through structural equation modeling, one-sample t-tests, Pearson correlation, and the Friedman ranking test. The results indicated that accrual accounting has a statistically significant positive effect on all examined dimensions (p<0.05). Optimal managerial decision-making showed the highest effect and ranked first among the dimensions. Transparency and service cost determination ranked second, followed by organizational effectiveness, performance-based budgeting, and managerial accountability. Friedman test results confirmed statistically significant differences among the ranked dimensions. Additionally, content analysis identified 41 key indicators associated with accrual accounting, highlighting its comprehensive role in accurate service costing. The findings demonstrate that implementing accrual accounting significantly enhances managerial decision-making quality, financial transparency, and organizational effectiveness in the healthcare sector, making it a powerful tool for improving public sector financial management.
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Copyright (c) 2025 Morad bakhsh Arbabi (Author); reza sotudeh (Corresponding author); Abolfazl Nejadali baghan (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
