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China’s ability to sustain the zero-COVID strategy over three years has garnered global attention, but little is known about the factors contributing to its long-term adherence. Based on the political promotion tournament model, this article theorizes that China’s strict administrative accountability system, which tied local officials’ career prospects to their performance in crucial policy goals, incentivized local governments to sustain COVID-19 policies. Using data from the Oxford COVID-19 Government Response Tracker and major official Chinese media outlets, we performed interrupted time series analysis (ITSA) to examine whether the accountability events affected the local government’s COVID-19 responses. Noticeably, our analyses found that from May 4, 2020, to September 30, 2022, when an accountability event happened, officials in the affected (local effects) and unaffected (spillover effects) provinces all increased their containment responses and decreased their economic support responses. This is true even for provinces without new localized outbreaks. The effects of accountability events increased with decreasing geographical distance. These findings remain consistent after several robustness checks. The administrative accountability system is a key institutional factor in implementing China’s zero-COVID strategy, which contributed to the global literature about the pandemic policy process in centralized countries.

This article proposes a conceptual framework that integrates the salient dimensions of accountability. It is based on an extensive review of the literature and draws on systems theory to develop an accountability system that can be applied to a wide range of organizations and contexts. It shows, through the accountability system presented, that organizations manage their accountability through stakeholder relationships, governance mechanisms, and information strategies, which are based on underlying values and purposes. This conceptual framework contributes to accountability theory by bridging different yet related concepts and clarifying the terminology used in the literature. Practically, conceptualizing accountability as an interconnected system can help organizations operationalize their accountability management practices. A hospital case study is used to demonstrate the applicability of the accountability system. [ABSTRACT FROM AUTHOR]

China is dedicated to enhancing the quality of its ecological environment, and the Central Environmental Protection Inspectorate (CEPI) system, which is an essential program for ecological civilization, has earned widespread acknowledgement for its efficacy in environmental improvement. This study investigated whether the CEPI accountability system contributed to enhancing the environmental quality by focusing on the CEPI accountability system. This study collected, explicitly, the number of people held accountable, the number of people being handed over for accountability, and the regions that the people held accountable were from; analyzed the current state of the CEPI accountability system in terms of the regional and batch differences in the accountability degree; and investigated whether the CEPI accountability system promoted environmental quality by using SPSS 10.00. The study discovered that, first and foremost, the CEPI system's scientific level has gradually improved, and the CEPI has been more precise in its accountability targets. Second, the CEPI enhances environmental quality, and significantly impacts wastewater-discharge reduction. Third, the CEPI system lacks sustainability. Finally, the paper presents several recommendations for enhancing the CEPI accountability system, with a particular focus on how to make the CEPI system more sustainable. [ABSTRACT FROM AUTHOR]

China's ability to sustain the zero-COVID strategy over three years has garnered global attention, but little is known about the factors contributing to its long-term adherence. Based on the political promotion tournament model, this article theorizes that China's strict administrative accountability system, which tied local officials' career prospects to their performance in crucial policy goals, incentivized local governments to sustain COVID-19 policies. Using data from the Oxford COVID-19 Government Response Tracker and major official Chinese media outlets, we performed interrupted time series analysis (ITSA) to examine whether the accountability events affected the local government's COVID-19 responses. Noticeably, our analyses found that from May 4, 2020, to September 30, 2022, when an accountability event happened, officials in the affected (local effects) and unaffected (spillover effects) provinces all increased their containment responses and decreased their economic support responses. This is true even for provinces without new localized outbreaks. The effects of accountability events increased with decreasing geographical distance. These findings remain consistent after several robustness checks. The administrative accountability system is a key institutional factor in implementing China's zero-COVID strategy, which contributed to the global literature about the pandemic policy process in centralized countries.

While the field of public management has long emphasized the importance of holding public employees accountable for their actions, our understanding of how best to do so has been hindered by a dearth of empirical research on this topic. Recent literature has called for more examination of individual subjective experiences of being accountable—employee accountability—in order to research how macro accountability systems make a difference to individuals. To validate the employee accountability construct in the public domain, we collect data from two separate samples using a multidimensional scale to measure public employee accountability. We analyze these data to explore the nomological network of public employee accountability by assessing its relationship with both a logical antecedent and expected outcomes. Based on findings that validate the nomological network, we discuss how this research contributes to the literature on accountability and possible directions for future research. [ABSTRACT FROM AUTHOR]

Innovation is needed to improve care of the seriously ill, and there are important opportunities as we transition from a volume- to value-based payment system. Not all seriously ill are dying; some recover, while others are persistently functionally impaired. While we innovate in service delivery and payment models for the seriously ill, it is important that we concurrently develop accountability that ensures a focus on high-quality care rather than narrowly focusing on cost containment. The Gordon and Betty Moore Foundation convened a meeting of 45 experts to arrive at guiding principles for measurement, create a starter measurement set, specify a proposed definition of the denominator and its refinement, and identify research priorities for future implementation of the accountability system. A series of articles written by experts provided the basis for debate and guidance in formulating a path forward to develop an accountability system for community-based programs for the seriously ill, outlined in this article. As we innovate in existing population-based payment programs such as Medicare Advantage and develop new alternative payment models, it is important and urgent that we develop the foundation for accountability along with actionable measures so that the healthcare system ensures high-quality person- and family-centered care for persons who are seriously ill. [ABSTRACT FROM AUTHOR]

Background: Successful implementation of a comprehensive accountability system for community-based serious illness care will require a robust data infrastructure. Data will be needed to support care delivery, quality measurement, value-based payment, and evaluation and monitoring. Objective: The specific data needs in these areas need to be identified and understood, so that gaps in currently available data may be addressed. Design: We developed a framework that includes the needed data and data infrastructure to support the features and characteristics of a serious illness care accountability system. Based on this framework, we analyze the current data landscape to identify gaps in available data resources and capacities. This analysis was informed by conducting Internet-based research, interviews with key informants, and a survey of key informants. Results: Based on the identified gaps, we present a series of priority recommendations for advancing the data infrastructure to support community-based serious illness care. These recommendations include additional measurement of patient-reported outcomes, increasing interoperability among various data sources, increasing development and exchange of patient care plans, leveraging newly standardized data on patient functional and cognitive status, and using patient-reported information for clinical decision support at the point of care. Conclusion: There are significant unmet data needs for a comprehensive accountability system in serious illness care, but these gaps can be prioritized and addressed through alignment and collaboration across stakeholders. [ABSTRACT FROM AUTHOR]