The research framework depicts the relationships between independent variables
(strategy, technology, organizational structure, external environment, and hospital size) and intervening variable (Management accounting system), and between intervening variable and dependent variable (managerial performance). This theoretical framework linking contextual variables to managerial performance through the use of Management accounting system is typically explained by the indirect relationships in which the type of strategies, level of technology, the type of structure, level of environment uncertainty, and hospital size; can enhance managerial decision making and performance when Management accounting system produces information that is broad, timely, integrated, and aggregated.