Title of the thesis:
The budget as a resource allocation tool: Layered and decoupled institutional logics in Norwegian municipal healthcare from a managerial perspective
Title of the trial lecture:
What is meant by budgetary incrementalism and what role does politics play in this process?
Trial lecture: 10:00
Public defence: 12:00
Members of the assessment committee:
Professor Antti Rautiainen, Jyväskylä School of Business and Economics (JSBE)
Associate Professor Trond Tjerbo, Department of Health Management and Health Economics, University of Oslo
Associate Professor Veronika Vakulenko, Nord University Business School (coordinator)
Supervisors:
Main supervisor: Professor Anatoli Bourmistrov, Nord University Business School
Co-supervisor: Professor Birgit Abelsen, UiT The Arctic University of Norway
The trial lecture and public defence are open to all interested attendees. The thesis is available by contacting Grete Knudsen at grete.i.knudsen@nord.no or by phone at +47 75 51 76 77.
Keywords from the thesis:
Norwegian municipal health and care services are under increasing pressure from demographic changes and growing expectations for individualised services, while municipalities face recruitment challenges and financial constraints. Nevertheless, resources continue to be allocated through traditional, hierarchical and incremental annual budgeting. How well this approach responds to changing needs and increasing institutional complexity is the question explored in this thesis: How is budgeting experienced and practised in Norwegian municipal health and care services, and what institutional conditions shape the budget’s role as a resource allocation tool in response to changing needs?
By combining public sector budgeting (PSB) as a domain theory with institutional logics as a theoretical lens, the thesis assesses the budget against a framework of intended budget functions and explores the conditions that shape these functions. Taking a pragmatic approach, the study integrates a systematic literature review, a mixed-methods survey of 123 municipal directors of health and care services, and a multiple-case study of three municipalities, based on 48 interviews across three management levels, together with documents and budget and accounting data.
The budget fulfils its intended functions only to a limited extent. Four distinct field-level logics are identified, governing long- and medium-term planning, budgeting and operations. These logics are layered across different time horizons in ways that promote inertia rather than incremental change. At the same time, mutually interacting loose couplings between elements of the budget cycle and across management levels constrain rather than enable local agency.
The thesis introduces the concept of intertemporal layering, extends the concept of decoupling into a cyclical framework across management levels, and identifies the interaction between these mechanisms as a novel finding for both streams of literature. For practice, the thesis translates these findings into recommendations to help municipalities recognise institutional complexity and improve the budget’s function as a resource allocation tool.
