The role of budgeting practices in Public Healthcare Organizations (PHOs) has become crucial since clinical heads of units have become budget holders and their traditional medical accountability has, therefore, been extended to include their financial accountability. The hybrid nature of "medico-managers" can induce risks related to their role ambiguity, which can affect their performance negatively. In order to mitigate these effects, the budgeting process’s effective organizational support for their managerial role could make a significant contribution.
Based on organizational support theory and adopting a behavioral management accounting perspective, this paper explores effectiveness of clinical managers’ budgetary participation with regard to enhancing their job satisfaction, as well as work engagement’s mediating effect on the job satisfaction-managerial performance link. Using a questionnaire, the authors collected data on a sample of clini-cal managers of Italian PHOs and used a regression analysis to test the research hypotheses. The results provide significant insights into psychological variables’ mediating role in the link between budgeting practices and PHOs’ performance, confirming that budgetary participation has a direct effect on clinical managers’ job satisfaction, while work engagement fully mediates the job satisfaction-managerial performance link.
Keywords: Behavioral Management Accounting in PHOs, Organizational support theory, Budgetary participation, Job satisfaction, Work engagement, Managerial