RESUMEN
The integration of social and environmental issues into their business model is today a major issue for companies facing the challenge of sustainability. This is leading them to redefine their models of performance measurement. In this perspective, integrated and multi-dimensional frameworks such as Balanced Scorecards (BSCs) and Sustainability Balanced Scorecards (SBSCs) offer attractive opportunities. Drawing on a systematic literature review (SRL), this article provides an analysis of the literature to identify the main trends in research on (S)BSCs and their contribution to CSR and sustainability issues. While the SLR reveals a major stream of instrumentalist and functionalist research aimed at demonstrating the relevance of SBSC in the strategic alignment of CSR, more critical approaches question the foundations, purposes and architecture of these instruments regarding the macroscopic challenges of sustainability. More precisely, focused on an organizational performance measurement, these tools would struggle to embrace the full complexity of sustainability issues. The article contributes novel insights to expand current models of SBSC from the perspective of a real contribution to strong sustainability challenges.
Asunto(s)
Responsabilidad Social , Conservación de los Recursos NaturalesRESUMEN
BACKGROUND: Accurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre. METHODS: Two thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC) model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions. RESULTS: The correlation coefficient amounted to 0.73 (95%CI: 0.72; 0.76). The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Betaâ=â-2.4; pâ=â0.02), ASA score (Betaâ=â76.3; p<0.001), RCI (Betaâ=â5.5; p<0.001), staffing level (Betaâ=â437.0; p<0.001) and intervention duration (Betaâ=â-10.5; p<0.001). CONCLUSIONS: The ability of the current method to provide relevant information to managers, clinicians and payers is questionable. As in other European countries, a shift towards time-driven activity-based costing should be advocated.