In this paper, we present an analysis of how activity-based costing (ABC) was included among austerity policy prescriptions within the healthcare sector. Relying on the proposition that an increasing quality of outcomes is achievable simultaneously with a reduction in costs, ABC straddled tensions between the logics of care and business for clinicians but not for administrators. We draw on case study research and use institutional logics and related approaches to analyze how the introduction of ABC became a device that improved communication by clinicians with administrators. When actors’ interests and motivations were aligned, ABC was able to offer professional clinicians value in the hospital in question. The study demonstrates how and why competing logics can coexist where there is ability to affect decision-making.

中文翻译：

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ABC 项目：医院医疗保健中意想不到的亲和力和影响

在本文中，我们分析了如何将作业成本法（ABC）纳入医疗保健行业的紧缩政策处方中。ABC 认为，在降低成本的同时可以提高结果质量，它为临床医生（而非管理者）跨越了护理逻辑和业务逻辑之间的紧张关系。我们借鉴案例研究，并使用制度逻辑和相关方法来分析 ABC 的引入如何成为改善临床医生与管理者沟通的工具。当参与者的兴趣和动机一致时，ABC 就能为相关医院的专业临床医生提供价值。该研究展示了竞争逻辑如何以及为何能够在有能力影响决策的情况下共存。