Introduction: Management of financial resources in health systems is one of the major issues of concern for
policy makers globally. As a sub-set of financial management, accounting system is of paramount importance. In
this paper, which presents part of the results of a wider research project on transition process from a cash
accounting system to an accrual accounting system, we look at the impact of components of change on
implementation of the new system. Implementing changes is fraught with many obstacles and surveying these
challenges will help policy makers to better overcome them.
Methods: The study applied a quantitative manner in 2012 at Kerman University of Medical Science in Iran. For
the evaluation, a teacher made valid questionnaire with Likert scale was used (Cranach’s alpha of 0.89) which
included 7 change components in accounting system. The study population was 32 subordinate units of Kerman
University of Medical Sciences and for data analysis, descriptive and inferential statistics and correlation
coefficient in SPSS version 19 were used.
Results: Level of effect of all components on the implementation was average downward (5.06±1.86), except for
the component “management & leadership (3.46±2.25)” (undesirable from external evaluators’ viewpoint) and
“technology (6.61±1.92) and work processes (6.35±2.19)” (middle to high from internal evaluators’ viewpoint).
Conclusions: Results showed that the establishment of accrual accounting system faces infrastructural
challenges, especially the components of leadership and management and followers. As such, developing
effective measures to overcome implementation obstacles should target these components.