Massimo Sargiacomo, Daniel E. MartÃnez, Stefania Servalli, Antonio Gitto · 5 authors
Purpose This study aims to examine how hospitals and regional and local health authorities in the Italian region of Marche accounted for and reported the use of emergency funds from the EU, the Ministry of Economic and Finance and administrative bodies called actuator subjects. Unlike a sudden impact disaster, such as an earthquake, the pandemic was slow moving and novel. This meant that the guidelines for medical, legislative, financial and administrative action were not as developed as those for sudden impact emergencies with which the Italian state was, unfortunately, experienced. Design/methodology/approach The paper investigates the Italian public healthcare setting since the declaration of the State of Emergency until its end—that is, from January 2020 to July 2021. We conducted 31 semi-structured interviews with nine key-actors working for national, regional and local administrative bodies. A range of related official documents were analyzed. Findings We show a non-linear and emergent account of standardization and coordination. We show how different state and transnational actors developed their own procedures to standardize COVID-related cost classifications and reports. These attempts also involved coordinating assemblages, at the center of which are templates imposed on hospitals and regional authorities by national state entities for cost-reporting practices and aggregation. Importantly, templates’ visual features enabled coordination across the different standardization initiatives that populated the emergency response effort. Research limitations/implications The paper provides academics and policy makers with insights into the role played by accounting tools, templates, reports and guidelines to coordinate different cost standardization initiatives. Originality/value Accounting guidelines that standardize costs are known to be deployed hierarchically by states and transnational organizations for coordination purposes. We highlight, however, the emergence of not only hierarchical forms of coordination but also their interrelation with decentralized forms of coordination. These two types of coordinating assemblages, each standardizes cost through the accounting templates that they use. We demonstrate the emergent nature of coordination even within hierarchical entities like the state. Reporting templates are pivotal for understanding this coordination process. However, when a centralized coordinating body is absent, it is the visual features of accounting, rather than its imposition, that enable coordination.