의료서비스 영역 내부통제 활성화를 위한 조직구조 요인 : 의료기관 종사자 인식조사 기반 = Organizational Determinants of Internal Control Activation in Healthcare Services: Evidence from Healthcare Employee Perceptions

다국어 초록 (Multilingual Abstract)

This study aims to identify organizational structural factors that activate internal
control in the medical service domain. Using the INTOSAI(International Organization of
Supreme Audit Institutions) internal control framework as the analytical lens, we examine
which organizational placements and statuses within hospitals facilitate the perception,
acceptance, and enactment of internal control. To this end, a perception-based survey
was administered to healthcare employees, and perceived levels of internal control were
compared across organizational structures, including the composition of control-related
units and their reporting lines.
The analysis indicates that institutions in which the Quality Improvement (QI)
department reports directly to the chief executive exhibit markedly higher perceptions of
internal control activation in clinical settings. These heightened perceptions, in turn,
show an indirect pathway toward more favorable views of the effectiveness of internal
control innovation. By contrast, the mere existence of an internal audit department or
the presence of a standing auditor does not display a meaningful association with
perceptions of internal control or with perceived effectiveness in the clinical domain.
Taken together, the findings suggest that the organizational status and placement of QI
are pivotal variables in designing internal control for healthcare institutions. They further
imply that effective application of the INTOSAI model to healthcare requires redefining
the role of internal audit in clinical control activities and developing a control model
strategically aligned with QI. This alignment would help institutionalize acceptance and
execution of control activities and provide a more sustainable foundation for internal
control in the medical service domain.