What are the determinants of internal auditing (IA) introduction and development? Evidence from the Italian public healthcare sector

Abstract

IMPACT This article sheds light on the reasons for practice variation in internal auditing (IA) introduction and development. From a policy perspective, the article’s findings highlight the relevance of accounting and accountability reforms as a crucial step for developing a new ‘awareness’ of the importance of internal controls and illustrate how IA can provide assurance on the internal control system. A further implication is that there is no ‘one-size-fits-all’ solution because different contexts need different IA models to mitigate the power and interests of the actors involved to ensure that IA is effective in terms of day-to-day activities.