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Saggi

No. 128 (2023)

If you have everything under control, you’re not moving fast enough: Internal Audit of intramoenia activities in the Veneto Region

DOI
https://doi.org/10.3280/mesa2023-128oa18597
Submitted
ottobre 2, 2024
Published
2024-11-28

Abstract

This study focuses on the Internal Audit function and is aimed at examining its value-adding role and its contribution to: (i) the improvement of organizational processes; (ii) the activities performed by the first and the second line of defense; (iii) the consistency of the whole Internal Control System. To this end, the study adopts a qualitative methodology and presents the experience from the Veneto RHS, which is one of the most relevant in the Italian NHS. In particular, it exemplifies how internal auditors perform their duties while auditing the intramoenia process (that is the professional activity that a doctors can perform privately within the public healthcare organizations).
Results show Internal Audit value-adding role. The study also identifies the opportunities and threats that may occur while performing an Internal Audit.

References

  1. Allegrini M., D’Onza G. (2003). IA and risk assessment in large Italian companies: an empirical survey. International Journal of Auditing, 7(3): 191-208. DOI: 10.1046/j.1099-1123.2003.00070.x.
  2. Anessi Pessina E., Cantù E., Persiani N. (2011). Armonizzazione contabile e revisione dei bilanci nelle aziende sanitarie pubbliche. In Anessi Pessina E., Cantù E. (a cura di). L’Aziendalizzazione della Sanità in Italia. Rapporto Oasi. Milano: Egea.
  3. Anessi Pessina E., Barbera C., Langella C., Sicilia M. (2021). Un’analisi sistematica degli articoli in tema di sistemi informativo-contabili pubblicati su Azienda Pubblica nel periodo 2008-2020. Azienda Pubblica, XXXIV(4): 329-369.
  4. Arena M., Azzone, G. (2007). Internal audit departments: adoption and characteristics in Italian companies. International Journal of Auditing, 11(2): 91-114. DOI: 10.1111/j.1099-1123.2007.00357.x.
  5. Barzan E., Notarnicola E., Rota S. (2018). La certificabilità dei bilanci delle aziende sanitarie: modelli, stato dell’arte e implicazioni dei PAC regionali. In CERGAS – Bocconi (a cura di). Rapporto OASI 2018. Osservatorio sulle Aziende e sul Sistema sanitario Italiano. Milano: Egea. -- https://cergas.unibocconi.eu/sites/default/files/files/Capitolo-8-OASI-2018.pdf.
  6. Braganti M., Persiani N. (a cura di) (2002). Il controllo di regolarità amministrativo-contabile sulle procedure delle aziende sanitarie ed ospedaliere. Milano: FrancoAngeli.
  7. Borsa Italiana (2018). Codice di Autodisciplina. -- https://www.borsaitaliana.it/comitato-corporate-governance/codice/2018clean.pdf.
  8. Cantarelli P., Lega F., Longo F. (2017). La regione capogruppo sanitaria: assetti istituzionali e modelli organizzativi emergenti. In CERGAS – Bocconi (a cura di). Rapporto OASI 2017. Osservatorio sulle Aziende e sul Sistema sanitario italiano. Milano: Egea. -- https://cergas.unibocconi.eu/sites/default/files/files/Capitolo-9.pdf.
  9. Cantù E. (2014). Il bilancio delle Aziende di Servizi Sanitari. Milano: Egea.
  10. Coetzee P., Erasmus L.J. (2017). What drives and measures public sector internal audit effectiveness? Dependent and independent variables. International Journal of Auditing, 21(3): 237-248. DOI: 10.1111/ijau.12097.
  11. CoSO (2013). Internal Control — Integrated Framework. Executive Summary, May 2013. Committee of Sponsoring Organizations of the Treadway Commission. -- https://www.coso.org/Documents/990025P-Executive-Summary-final-may20.pdf.
  12. CoSO (2017). Enterprise Risk Management – Integrated Framework – Aligning risk with strategy and performance. Committee of Sponsoring Organizations of the Treadway Commission. -- https://www.coso.org/documents/2017-coso-erm-integrating-with-strategy-and-performance-executive-summary.pdf.
  13. Dittmeier C.A. (2011). Internal Auditing: Chiave per la corporate governance. Milano: Egea.
  14. Ferry L., Zakaria Z., Zakaria Z., Slack R. (2017). Watchdogs, helpers or protectors? – Internal auditing in Malaysian Local Government. Accounting Forum, 41(4): 375-389. DOI: 10.1016/j.accfor.2017.10.001.
  15. Gigli S. (2014). La certificazione delle procedure amministrative nelle aziende sanitarie pubbliche: alcune riflessioni. Mecosan, 89: 103-124. DOI: 10.3280/MESA2014-089007.
  16. Hay D., Cordery C. (2020). Public Sector Audit. London: Routledge.
  17. Institute of Internal Auditors (2013). IIA Position Paper: The Three Lines of Defense in Effective Risk Management and Control [Brochure]. Florida, USA: Altamonte Springs.
  18. Inyang O.E., Enya E.F., Otuagoma O.F. (2021). Internal Audit Effectiveness in the Public Health Sector in South-South Nigeria. United International Journal for Research & Technology, 02(08): 127-132.
  19. Khelil I., Khlif H. (2022). Internal auditors’ perceptions of their role as assurance providers: a qualitative study in the Tunisian public sector. Meditari Accountancy Research, 30(1): 121-141. DOI: 10.1108/MEDAR-04-2020-0861.
  20. Kotb A., Elbardan H., Halabi, H. (2020). Mapping of internal audit research: a post-Enron structured literature review. Accounting, Auditing & Accountability Journal, 33(8): 1969-1996. DOI: 10.1108/AAAJ-07-2018-3581.
  21. Langella C., Anessi Pessina E., Cantù E. (2020). Caratteristiche e attività del Collegio Sindacale nelle aziende sanitarie pubbliche italiane. Mecosan, 116: 53-73.
  22. Langella C., Vannini I.E., Persiani N. (2023). What are the determinants of internal auditing (IA) introduction and development? Evidence from the Italian public healthcare sector. Public Money & Management, 43(3): 268-276. DOI: 10.1080/09540962.2022.2129591.
  23. Langella C., Vannini I.E., Persiani N., Marciacano M. (2022). L’Internal Auditing nel Servizio Sanitario Nazionale: l’esperienza della Regione Veneto e della Regione Emilia-Romagna. Mecosan, 123: 7-27.
  24. Luburic R., Perovic M., Sekulovic R. (2015). Quality Management in Terms of Strengthening the “Three Lines of Defence” in Risk Management – Process Approach. International Journal for Quality Research, 9(2): 243-250.
  25. Marchi L. (2019). Revisione aziendale e sistemi di controllo interno. Milano: Giuffrè Francis Lefebvre.
  26. Mattei G., Grossi G., Guthrie A.M., J. (2021). Exploring past, present and future trends in public sector auditing research: a literature review. Meditari Accountancy Research, 29(7): 94-134. DOI: 10.1108/MEDAR-09-2020-1008.
  27. Mihret D.G., Grant B. (2017). The role of IA in corporate governance: a Foucauldian analysis. Accounting, Auditing & Accountability Journal, 30(3): 699-719. DOI: 10.1108/AAAJ-10-2012-1134.
  28. Nerantzidis M., Pazarskis M., Drogalas G., Galanis S. (2022). IA in the public sector: a systematic literature review and future research agenda. Journal of Public Budgeting, Accounting & Financial Management, 34(2): 189-209. DOI: 10.1108/JPBAFM-02-2020-0015.
  29. Nordin I.G. (2023). Narratives of internal audit: The Sisyphean work of becoming “independent”. Critical Perspectives on Accounting, 94, 102448. DOI: 10.1016/j.cpa.2022.102448.
  30. Nurdiono N., Gamayuni R.R. (2018). The effect of internal auditor competency on internal audit quality and its implication on the accountability of local government. European Research Studies Journal, 21(4): 426-434.
  31. Persiani N. (2008). Principi contabili e di controllo interno per le aziende sanitarie ed ospedaliere. Milano: FrancoAngeli.
  32. Persiani N. (2012). Il controllo contabile del bilancio degli enti del S.s.n.: verso la certificabilità dei dati e dei bilanci. Ragiusan, 344: 28-36.
  33. Roussy M. (2013). Internal auditors’ roles: From watchdogs to helpers and protectors of the top manager. Critical Perspectives on Accounting, 24(7-8): 550-571. DOI: 10.1016/j.cpa.2013.08.004.
  34. Roussy M. (2022). Engaging in internal audit research... in the public sector no less: A Hara‐kiri for your academic career? No way! Canadian Journal of Administrative Sciences, 39(3): 347-352. DOI: 10.1002/cjas.1661.
  35. Roussy M., Perron, A. (2018). New Perspectives in Internal Audit Research: A Structured Literature Review. Account Perspectives, 17(3): 345-385. DOI: 10.1111/1911-3838.12180.
  36. Schillemans T., van Twist M., van der Stehen M., de Jong I. (2018). New development: Breaking out or hanging on? Internal audit in government. Public Money & Management, 38(7): 531-534. DOI: 10.1080/09540962.2018.1527574.
  37. Thomasson A. (2018). Politicisation of the audit process: the case of politically affiliated auditors in Swedish local governments. Financial Accountability and Management, 34(4): 380-391. DOI: 10.1111/faam.12158.
  38. White S., Bailey S., Asenova D. (2020). Blurred lines: exploring internal auditor involvement in the local authority risk management function. Public Money & Management, 40(2): 102-112. DOI: 10.1080/09540962.2019.1667682.
  39. Woods M. (2011). Risk Management in Organizations: An Integrated case study approach. New York, USA: Routledge.
  40. Yin R.K. (2018). Case study research and applications. Design and methods. Sage.

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