Roles of Non-Traditional Gatekeepers in Healthcare Governance: Case Study of a Canadian First Nations

35 Pages Posted: 16 Jan 2018 Last revised: 13 Mar 2018

See all articles by Akolisa Ufodike

Akolisa Ufodike

MacEwan University School of Business; University of Calgary

Oliver N. Okafor

Ryerson University - Ted Rogers School of Management

Dominic Roberts

Grant MacEwan University - Department of Accounting and Finance

Date Written: February 1, 2018

Abstract

While prior studies of gatekeepers have examined the roles of traditional gatekeepers defined as professionals with normative isomorphic obligations, this study explores the roles of non-traditional gatekeepers in an alliance that is neither hierarchical nor market based. Drawing on new institutional theory, our study investigates the roles that non-traditional gatekeepers play in Aboriginal health care delivery and how accounting is implicated. Canada’s Health Centre of the Paul Band is our site of investigation.

We find that three themes bear on the roles of non-traditional gatekeepers on Aboriginal health care governance: 1) eco-system control, 2) resource control and, 3) program control. We also find that accounting helps to facilitate the execution of these governance roles through internal and cost control mechanisms. Accounting inculcates standardized practices that are useful in resolving tensions in the health care alliance, but accounting controls also create bureaucratic restraints that have the unintended consequences of limiting access to health care and causing tensions in the alliance.

Keywords: Gatekeepers, Auditors, First Nations, Institutional Theory

Suggested Citation

Ufodike, Akolisa and Okafor, Oliver N. and Roberts, Dominic, Roles of Non-Traditional Gatekeepers in Healthcare Governance: Case Study of a Canadian First Nations (February 1, 2018). 2018 Canadian Academic Accounting Association (CAAA) Annual Conference. Available at SSRN: https://ssrn.com/abstract=3102581 or http://dx.doi.org/10.2139/ssrn.3102581

Akolisa Ufodike (Contact Author)

MacEwan University School of Business ( email )

P.O. Box 1796
Rm 5-256F
Edmonton, Alberta T5J 2P2 T5J4S2
Canada

HOME PAGE: http://www.macewan.ca

University of Calgary ( email )

2500 University Drive, NW
Calgary, Alberta T2N 1N4
Canada
4039192561 (Phone)

HOME PAGE: http://www.ucalgary.ca

Oliver N. Okafor

Ryerson University - Ted Rogers School of Management ( email )

350 Victoria Street
Toronto, Ontario M5B 2K3
Canada

HOME PAGE: http://https://www.ryerson.ca/accounting-finance/faculty/oliver-okafor/

Dominic Roberts

Grant MacEwan University - Department of Accounting and Finance

P.O. Box 1796
Rm 5-256F
Edmonton, Alberta T5J4S2
Canada

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