A Comparative Study Of Expenditure Control Methods In Government And Privately Owned Hospitals. (a Study Of University Of Nigeria Teaching Hospital, Enugu And Toronto Hospital Onitsha)

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ABSTRACT
This research work on A Comparative Study of Expenditure Controls method in Government and private Hospitals is aimed at studying and analysing the different methods of expenditure control that is being adopted by these hospitals, their practical application and their level of effectiveness. It is aimed at carrying out a comparative analysis of two hospitals. To achieve the aim of this research, secondary data through textbooks and journals were used to review some of the related literatures. Equally, questionnaires, interview and observation, which sought to find out facts needed for analysing, were used. The questionnaires were analyzed by simple percentages while hypothesis were tested using chi-square statistics. The findings of the analysis indicate among others that the method of expenditure control used by both hospitals are not the same; The daily control method for private hospitals and the vote card method for Government Hospitals. The different methods of expenditure control used by the two hospitals are effective, but with slight loopholes associated with vote card method. I recommend among others that both hospitals should adhere strictly to authorization procedure for drug purchased and materials purchases. Both hospitals should exhibit high degree of cash management and employ competent personnel for proper and efficient expenditure control.
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TABLE OF CONTENTS
Approval page ii
Certification page iii
Dedication iv
Acknowledgement v
Abstract vii
Chapter One
1.0 Introduction 1
1.1 Background Of The Study 1
1.2 Statement Of the Problem 4
1.3 Objectives Of The Study 6
1.4 Research Questions 6
1.5 Formulation Of Hypotheses 7
1.6 Significance Of The Study 8
1.7 Scope Of The Study 9
1.8 Limitations Of The Study 9
1.9 Definitions Of Terms 10
Chapter Two
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2.0 Review Of Related Literature 12
2.1 Introduction 12
2.2 Overview Of Expenditure Control 12
2.3 The Expenditure Control Methods 14
2.4 Internal Auditing Overview 19
2.5 Management Audit 25
2.6 Cost Benefit Analysis 27
2.7 Quantitative Models For Expenditure Control 28
2.8 Items Related To the Income Generated In A Hospital 32
2.9 Items Related To The Expenditure Of A Hospital 36
2.10 The Expenditure Control Method That Are In Application 37
2.11 Vote Card Method of Expenditure Control 42
Chapter Three
Research design and Methodology
3.0 Introduction 45
3.1 Sources of Data 46
3.2 Research Instrument 47
3.3 Reliability and Validity of Research Instrument. 48
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3.4 Population 49
3.5 Sample Size/Technique 50
3.6 Administration Of Research Instrument 52
3.7 Method Of Data Analysis 52
3.8 Decision Criterion For Validation Of Hypotheses 53
Chapter Four
4.0 Data Presentation and Analysis 54
4.1 Data Analysis/Presentation 54
4.2 Testing Of Hypotheses 67
4.3 Discussion of Findings 75
Chapter Five
5.0 Summary of findings, Conclusion and Recommendations 78
5.1 Summary of findings 78
5.2 Conclusion 79
5.3 Recommendation s 79
Bibliography 82
Appendix 1 85
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Appendix 2 86
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CHAPTER ONE
1.0 INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Expenditure control or cost control is part of management control process, in every organisation.
This process is very important to any organisation be it profit making organisation or non-profit making organisation. Thus, lack of this practice in any organisation will cause misapplication of cash in cash disbursement process and this will create a very big problem leading the organisation into deficit and at an extreme case, the organisation might wind up. Many researches have been conducted in the reason for winding up of companies and organisation in which lack of expenditure control process had found responsible.
Expenditure control has been defined as the process by which managers utilize effectively and efficiently, the scarce resource in the achievement of the organisational goals. At this juncture, let us look at expenditure and control from separate perspective.
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Expenditure is the total amount spent on the process of trying to achieve a particular organisational goal. Control means to order, limit, instruct or rule something or someone’s actions. It is used by either government officials or organisation managers to make restrictions on wages increases, immigrate credit and so on (which are all expenditure).
As regards, this research work, which is the comparative study of expenditure control methods in government and privately owned Hospitals, A study of the University of Nigeria Teaching Hospital Enugu (UNTH) and Toronto Hospital and Maternity Onitsha; this implies a comparative study of non-profit making organisations, since UNTH is government owned Hospital while Toronto Hospital is privately owned Hospital as a category of profit making organisation. Non-profit making organisations are characterized by the following:
a) There is neither a conscious profit motive nor an expectation of earning net income.
b) No profit of any excess of revenue over expenditure is distributed to those who contributed support through taxes and voluntary donations.
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In profit making organisations, the reverse of these characteristics is the case in the sense that their major objective is to maximize profit and excess of revenue over expenditure are given to the owners of the organisation.
Government owned hospitals pay more attention to services they render to the public, as their major objectives is to provide services that fulfil a social needs for those who do not have the purchasing power to acquire these services themselves. Irrespective of the fact that privately owned hospitals try to render good and quality services to the public, they pay more attention to maximize of profit which their major objective.
Comparative study of expenditure control in Government and privately owned Hospital which is major research question in this research work has to with the different ways and methods by which expenditure is being controlled in each of the hospitals so that they will not run into deficit or liquidations.
According to Johnson (1976), the management control concept which imbibes the expenditure control are the same both in profit oriented and non-profit oriented organisations, but the implication of these concepts
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differ in important respect. We will want to find out if also the expenditure control methods are the same or differ in the two hospitals under study, owning to the fact that one is profit oriented and the other is non-profit oriented.
1.2 STATEMENT OF THE PROBLEM
The problems encountered by the Government and privately owned Hospitals in expenditure control are as follows: The problem of daily control method and the vote card method. The problem encountered is to know the effective method to use in the two hospitals. Here, the problem encountered is to check whether the daily control method will be efficient and effective in the Government owned hospitals or whether the vote card method is the best. Another problem encountered by the hospitals in expenditure control is the problem of internal control. Internal control is the essential feature of an organisation, be it profit making or non-profit making, and it is expected to be well managed effectively and efficiently. Any
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problem or limitation of the internal control will pose a problem to the expenditure control of the organisation.
Therefore, the above problems encountered by the two hospitals are the problems of expenditure control methods encountered by the government and privately owned hospitals by the government and privately owned hospitals that attracted the attention of the researcher.
The problem definition in this research work is to investigate and analyse the different ways and methods by which expenditure is controlled in government owned hospitals and privately owned hospitals so that they will not run into deficit and liquidation. As a comparative study, two hospitals has been selected for the study, they are: University of Nigeria Teaching Hospital Enugu (UNTH) for government owned Hospitals, and Toronto Hospital and Maternity Onitsha for privately owned hospitals.
In this research, we study the different methods of expenditure control being adopted by these hospitals and their practical application and their level of effectiveness.
This study will form a basis for our analysis which will help to answer some research questions.

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