Casemix accounting systems and medical coding:organisational actors balanced on "leaky black boxes"

The adoption of DRG coding may be seen as a central feature of the mechanisms of the health reforms in New Zealand. This paper presents a story of the use of DRG coding by describing the experience of one major health provider. The conventional literature portrays casemix accounting and medical coding systems as rational techniques for the collection and provision of information for management and contracting decisions/negotiations. Presents a different perspective on the implications and effects of the adoption of DRG technology, in particular the part played by DRG coding technology as a part of a casemix system is explicated from an actor network theory perspective. Medical coding and the DRG methodology will be argued to represent ``black boxes''. Such technological ``knowledge objects'' provide strong points in the networks which are so important to the processes of change in contemporary organisations.

Irrelevant or transformative power? The OECD DAC and foreign aid policies in Central and Eastern Europe

The paper examines the impact of the OECD’s Development Assistance Committee (DAC) on the emerging foreign aid policies of the Central and Eastern European (CEEs) countries. The Czech Republic, Poland, Slovakia and Slovenia joined the DAC in 2013, and the committee has aimed to socialise them into the norms of the international development system. Generally, however, there is little evidence of impact due to the soft nature of the DAC’s policy recommendations, and the fact that the committee, reacting to the challenges to its legitimacy from non-Western donors, has become much less demanding towards potential members than in the past. The paper, however, argues that one must examine the processes of how the norm and policy recommendations of the DAC are mediated domestically. The case of the Czechepublic’s reforms in its foreign aid policy between 2007 and 2010 shows that domestic actors can use the OECD strategically to build support for their own cause and thus achieve seemingly difficult policy reform.