Healthcare budgeting for cyclicality: Structured literature review of accounting, public administration and ­­­health management

IMPACT: This article warns that cyclical stocks are affecting the delivery of routine healthcare services. Planning fails when a shock occurs and policy-makers and managers need to adapt to budgetary over-estimation. To ensure a sustainable level of services at all stages of the economic cycle, cyclical impact should be systematically determined. This would improve decision-making and help minimize institutional and political impediments. However, developing these capabilities is difficult, requiring a multi-year perspective to be incorporated into the annual budgeting process. An important prerequisite to do this is for stakeholders to understand the impact that cyclicality has on healthcare.