In the context of hospitals, the health care literature strongly suggests the use of highly refined cost systems to enable hospitalmanagers to respond to growing pressure to control costs in this rapidly changing industry (Hill and Johns, 1994; Pizzini, 2006). Pizzini (2006) argued that the health care industry provides the opportunity to sample from a large number of complex organizations that operate under similar circumstances, offering relatively standardized services. Furthermore, Chenhall (2003) suggested that there is a need for more contingency-based research in the service and not-for-profit organizations, as such entities become increasingly important in most economies.