FINANCIAL INFORMATION IN PUBLIC HEALTHCARE ORGANISATIONS: DEMAND, REGULATION AND THE WORKING CAPACITY OF THE ACCOUNTING METHOD

Public healthcare organisations in transition economies are increasingly expected to produce financial information that supports tariff setting, capacity planning and performance assessment, while the statutory reporting framework has traditionally been oriented toward confirming budget execution. This paper examines the extent to which the accounting system of a public medical organisation fulfils its informational function and identifies areas in which its analytical and managerial potential can be further strengthened. The study draws on the complete 2019–2025 reporting archive of four Uzbek public medical organisations, comprising more than 250 primary statutory reports, of which 73 filings across eight form families constitute the main research object. The analysis proceeds on three levels: the demand for information, the regulatory architecture of accounting, and the working capacity of the eight classical elements of the accounting method. Three main findings are reported. First, institutional information is produced in three layers that could benefit from closer methodological coordination, while two of the six identified classes of management decisions are fully supported by the statutory report set. Second, the third tier of regulation, which is developed at the organisational level, demonstrates considerable potential for further formalisation: accounting policy, the document-flow schedule and internal control procedures were not identified in the examined archives, whereas externally regulated accounting requirements were consistently observed. Third, among the eight elements of the accounting method, one operates fully, five operate partially, and two are not directly reflected in the statutory reporting forms; a separate costing mechanism was not identified in the available documentation. Because accrued depreciation is not included in expenditure, the reported cost of services may be 7.4–11.0 per cent lower than a full-cost measure, while the depreciation ratio increased from 44.2 to 61.5 per cent over five years. Inter-form articulation tests indicate that the principal opportunity for improving informational consistency arises at the aggregation stage rather than at the ledger level. The paper concludes that the existing system provides a reliable basis for monitoring the allocation and use of financial resources, while further development of cost accounting and analytical reporting could expand its capacity to assess the economic results of healthcare service delivery.

Hali tarjima qilinmagan