Factors Affecting the Adoption of Computerized Accounting Systems: Case Study of Private Hospitals in Sulaymaniyah

An accounting information system may be computerized and based on information technology, manually operated, or it may be in the middle. Regardless of the method chosen; the process remains the same. Financial data must be gathered, entered, processed, stored, and reported via an accounting information system. The Information is produced using technology and software that might be either manual or computerized (Hamasalih et al., 2025). Computerized accounting software is designed to track a company's financial activities and provide annual, quarterly, or monthly financial reports based on the company's preferences. It can also be used to generate tax returns and other reporting options (Salih, 2020). Evaluate, analyze, and evaluate the profitability and operational performance of the business (Abdullah et al., 2020). The environment in developed and developing countries varies greatly. Furthermore, each developing nation's cultural, political, and economic realities are frequently very different from one another. Thus, it is preferable to refrain from creating a standard. prescription and offer suggestions without first considering the unique characteristics of every country. Consequently, it is imperative that we deepen our comprehension of the decision-making and execution processes involved in the adoption of computerized accounting information systems in particular developing countries such as Iraq. Private hospitals in Sulaymaniyah have started to implement computerized accounting systems (CAS) as the awareness about its benefits is growing, which includes better access to financial data, increased productivity and accurate reporting (Hameed et al., 2025). However, due to several obstacles including high implementation cost, staff with limited technical knowledge, reluctance to change manual procedures and data security concerns the impact on hospital operations is still unknown. To reap the benefits of CAS these obstacles must be addressed. Data security, organizational culture, staff readiness, training and financial resources must be considered. Private hospitals can improve financial management and fully enjoy the benefits of CAS by overcoming these challenges proactively (Hamasalih et al., 2025). To see what the status of computerized accounting systems is in private hospitals in Sulaimaniyah, type of system, features, and benefits. To identify the main challenges and barriers in adopting and implementing computerized accounting systems in private hospitals, such as staff training. Hence, to evaluate the effectiveness and efficiency of computerized accounting systems in financial management practices, data accuracy, reporting timeliness and financial information transparency. Further, to determine the variables affecting private hospitals in Sulaimaniyah in adopting and deploying computerized accounting systems. To inform recommendations for system improvement and customization for private hospital settings, this involves seeing the status, identifying major challenges and barriers, evaluating the systems and gathering information from finance staff, administrators and healthcare experts (Salih, 2021).

2. Theoretical framework and literature review

The healthcare sector is paying more attention to computerized accounting systems (CAS), especially in private hospitals, because of their potential to enhance operational effectiveness and financial management. With an emphasis on the special opportunities and challenges these facilities face, this chapter examines the factors influencing the adoption of CAS in Sulaimanyah's private hospital sector. The accounting system is a prerequisite for this environment. The hardware and software that make up the operating environment are what the accounting system uses to function. The hardware structure is determined by the software. The number of users, hardware preferences, privacy requirements, and the types of operations carried out by functional departments all influence the choice of hardware.  As a result, computerized accounting systems are built with several interconnected structural elements or subsystems that cooperate to carry out the accounting function as effectively and efficiently as possible, including gathering, recording, arranging, compiling, and evaluating business transactions, as well as providing stakeholders with financial data. A Computerized Accounting System (CAS) is a must-have for businesses looking to simplify financial management. With its user-friendly design, it handles everything from data entry and reporting to compliance with legal standards. Whether you're tracking bills, managing payroll, or planning budgets, a CAS ensures everything runs smoothly (ALshbiel, and Al-Awaqleh, 2011). It’s easy to install, doesn’t require a large IT team, and provides essential tools for managing assets, projects, and supply chains. By automating repetitive tasks and providing real-time insights, a CAS saves time, reduces errors, and keeps your finances organized. A computerized accounting system, according to systems theory, is the result of the integration of several parts or subsystems. The system's structural characteristics are represented by the architectural framework that these components comprise. Software architecture is the logical division of a program into several components with the goal of improving system dependability and performance. In his book, Development of Computerized, he stated that the hospital's computerized accounting system, as well as the creation and deployment of the network, not only altered the hospital's previous accounting management but also followed prevailing trends. The hospital's leadership must accurately recognize the benefits of the computerized accounting network system and provide strong support for its establishment and implementation. This is because the computerized accounting system, its establishment, and its implementation enhance the hospital's management level and market competitiveness to some extent. Western nations are certain that the adoption of computerized accounting systems will have positive social and economic effects. Automated accounting systems face challenges like data protection from viruses, power outages, and hacking. Control over access, particularly for customer data, are crucial. Management may be held accountable for data theft. Accurate data entry is essential, as a single error can cause data loss (Abdullah et al., 2025).   This segment incorporated studies by scholars, internationally, on how independent variable related to the dependent variable (Salih, 2025). Concepts influencing computerized system adoption and concepts affecting those systems' applicability differ from one another. Some researchers examined more general adoption concepts, like the theory of reasoned action or its relationship to the variables in the TAM model. Fatah, and Amin, (2023) carried out a study with the goal of implementing the Hospital Information System (HIS) in Malaysian tertiary hospitals. They investigated the factors that prevent implementation as lack of dedication, incapacity to supply a large information technology infrastructure, difficulty locating appropriate software and hardware, and shortage of qualified IT staff. Palani et al, (2025) conducted a study focusing on the journey towards creating a paperless hospital environment, using the Arusha Lutheran Medical Centre as a case study. He identified challenges hindering this transition, particularly the shortage of skilled personnel. According to Omar et al, (2025), costs, in the broadest sense, are the actual or probable sacrifices of financial resources expressed in monetary units that take place to achieve specific goals. Costs, in their strict sense, can be seen as the giving up of financial resources to acquire assets. The cost of a computerized accounting system consists of equipment costs, assembly costs, installation costs, and testing costs. Specially trained staff is needed to operate the system. Therefore, large training costs are incurred to understand hardware and software usage continuously because newer types of hardware and software are needed to ensure the effectiveness and efficiency of the use of computerized accounting systems. Qadir, & Fatah, (2023) reported on the factors influencing small businesses to use computerized accounting systems. The findings indicated that non-users of the accounting software (CAS) cited two main reasons: one was related to innovation, and the other was related to the decision-makers characteristics within the organization. The first justification (innovation element) was that a CAS would not benefit the company and was not necessary. The owner manager's lack of IT expertise was the second factor (a feature of the organizational decision maker). Based on the literature review mentioned above, the researcher came up with the following theory:

H1: There is a statistically significant relationship between foundation and computerization of the accounting system.

H2: The computerization of the accounting system and human resources has a statistically significant link.

H3: The cost and computerization of the accounting system are correlated in a statistically meaningful way.

H4: The computerization of the accounting system and administrative performance has a statistically significant correlation.

RESEARCH METHODOLOGY

This section explains the different approaches used to investigate the suggested research question (Rashidand Fatah, 2022). It outlines the sampling strategies, data collection procedures, kinds of data to be gathered, and data analysis strategies to be used throughout the entire investigation (Albright and Ingram, 2007). In this study, dependent variables are the adoption of CAS in private hospitals while independent variables are factors which affect adoption CAS in private hospitals (Yaqub et al., 2024). The relationship between and among these variables are presented diagrammatically for supplementary understanding of the factors affecting applicability of CAS in private hospitals.

3.1 Research design

The research design is a framework for strategic
action that connects the execution of the research strategy and the research questions.

3.2 Data collection methods                                     

To obtain information from respondents, the researcher employed questionnaires as a means of data collection.

3.3 Questionnaire

The study aims to understand the factors influencing the adoption of computerized accounting systems (CAS) in private hospitals in Sulaymaniyah (Rahman et al., 2021). The questionnaire consists of three sections: demographic data, examining the specifics of CAS, and examining the underlying factors influencing adoption. The first section gathers demographic data, while the second section evaluates the effectiveness of CAS in boosting organizational performance (Ali et al., 2024). The third section delves deeper into the underlying factors influencing CAS adoption, focusing on foundational aspects, human resources, cost considerations, and administrative performance. The knowledge gained from the respondents will enhance academic discussion and provide guidance for maximizing CAS integration in private hospital environments.

3.4 Population

The set or grouping of all the units to which the research findings are to be applied is referred to as the population.

3.5 Sample and Sampling procedure

A sample is a constrained portion of a statistical population that is studied in order to learn more about the population. In layman's words, it means choosing a group of respondents from a wider population, usually for a questionnaire (Salih, 2018). For example, I gave out questionnaires to the administrative staff at five Sulaymaniyah private hospitals, starting with the accountants and anyone else who might be aware of this system. A descriptive research methodology was employed by the study to collect data in these environments.

3.6 Sample size

By selecting the sample based on accountants and anyone else who is aware of this system, the researcher employed judgmental or intentional sampling. When there are few people with in-depth knowledge of the topic under investigation, this approach is usually employed.

3.7 Data Analysis and presentation methods

The collected data was analyzed by the researcher using the reliable statistical program SPSS, which made it possible to thoroughly examine statistical indicators and trends (Ahmed, 2017). The results were presented methodically by using expert tables, guaranteeing a methodical result presentation (Salih, 2021). For additional data processing and presentation, the researcher also used SPSS and tables. This included performing simple computations such as calculating the mean of each variable (Abdulrahman et al., 2025).

4. Findings

This section explores the use of factor analysis, scale analysis, and descriptive statistical analysis to evaluate the data. It also presents findings on the relationships between independent and dependent variables, specifically focusing on the factors influencing the adoption of computerized accounting systems in private hospitals in Sulaymaniyah (Yaqub, 2024). There were five hospitals used in the questionnaires, and therefore there were 16 questionnaires filled out by the employees of the hospitals (Barren, 2010). Seven questionnaires were returned, resulting in a response rate of 58.3%. The distribution plan involved assigning questionnaires to different employees, who then submitted them to their department heads (Fatah et al., 2021). After waiting for two to three days, the researcher collected the completed questionnaires from the department heads. Among them, five questionnaires were deemed suitable for analysis after filtering out invalid responses, representing a retention rate of 71.4%.

4.1 Position of education

Occupations of the Participants: Due to the novelty of using the computerized accounting system in private hospitals, individuals with relevant expertise were encouraged to fill out the form.

4.2 Computerized Accounting Systems

In this section, we will try to identify the systems that exist in our selected hospitals. It should be noted that the use of such systems is completely new in the history of Sulaymaniyah hospitals.

4.2.1Analysis of Types of Applications Employed for Computerized Accounting Systems in Private Hospitals

For the sake of simplicity and analysis, a consolidated list of software employed for the computerized accounting system in private hospitals has been developed by the researcher as presented in Table 1. These software components are the fundamental components that ensure effective and efficient management of financial data and accuracy in all fiscal activities carried out in health institutions (Fatah and Fatah, 2022). Regarding the applications specified by the responding hospitals, it is noteworthy that Harem Hospital uses Microsoft Excel. While Microsoft Excel has versatile capabilities, its use in this context suggests potential deficiencies in implementing more comprehensive and specialized accounting software solutions that fully meet the needs of private hospital accounting processes. The Faruk Medical City depends on billing software while the Westeye Hospital depends on Medware.Net. The Baxshin Hospital uses HMS and the Malik Poly Clinic uses its own software known as Malik Poly Clinic System. Each of the hospitals’ needs a different software depending on the needs of the hospital and the requirements of its financial department.

4.2.3Analyzing Perceptions: Computerized Accounting Systems in Private Hospitals

Table 2 shows mean scores of the questions asked in the questionnaire used to gather perceptions toward computerized accounting systems adoption among private hospitals. The nine questions in the questionnaire were each scored on a scale of Very Bad=1 to Excellent=5 and the mean scores represent aggregate perceived perceptions toward computerized accounting systems on aspects such as information accuracy, The mean scores represent aggregate perceived perceptions toward computerized accounting systems on aspects such as report availability, performance improvement, data security, reliability, influence of accounting standards, effectiveness for financial tasks, system development, operational efficiency, and productivity (Fatah, 2018).

The examined hospitals' perceptions of computerized accounting systems were largely positive (Aivas et al., 2025). However, since Excel was used by one of the hospitals, it is likely that some of the low perception scores regarding security, dependability, and customizability were caused by Excel's use. Therefore, in order to improve the hospital's computerized accounting systems' reputation and to increase efficiency and security in the storage and management of the hospital's financial data, it is necessary to switch to more sophisticated and specialized accounting software.

4.3 Foundation

This section explores the fundamental elements that are essential for the effective deployment of computerized accounting systems in private hospitals. In particular, we evaluate the staff members who are in charge of managing these systems as well as the accessibility of computers to facilitate system implementation. Every element is graded from "Very Bad" to "Excellent," offering information about the staffing capacity and technology setup that exist in the hospital setting today.

4.3.1Exploring Foundation: Technological Infrastructure, Staff Qualifications, and Computer Availability

The data shows a good setting for using computer accounting systems in hospitals. The technology and employee skills are good enough. Computers are very easy to find. This means hospitals have what they need to use these systems well (Yaqub, 2024).

4.4 Human resource

This part of the test delves into assessing the human resource dynamics pertinent to the integration of computerized accounting systems within the private
hospital. It encompasses three crucial inquiries, which were analyzed using mean statistics

4.4.1 Analyzing Human Resource Dynamics in Implementing Computerized Accounting Systems

We must check how our staff works to add new computer accounting systems to our private hospital. We will learn about the training of our employees, how many skilled employees we have, and if our staff can use the new system. Knowing this, we can plan better to make the system work well and fast.

The data emphasizes how important human resources are to the private hospitals' successful implementation of computerized accounting systems. Although the presence of experienced staff members and their availability are considered assets, it is evident that more training and knowledge are required to properly support the change (Hussein et al., 2024).

4.5 Cost

This table provides a summary of the cost assessment findings concerning the implementation of computerized accounting systems within hospitals. The data presented is drawn from research examples. It outlines respondents' views on the financial impacts and resource allocations linked to the adoption of such systems (Kareem el at., 2021).

4.5.1Analyzing Cost Implications of Implementing Computerized Accounting Systems

Table 5 indicates a favorable attitude toward the adoption of computerized accounting systems; however, the fact that one hospital still uses Excel for accounting tasks points to the possibility that this decision should be reexamined. Excel is widely used, but there are risks associated with its inefficient handling of large volumes of data, lack of strong security features, and error-prone manual data entry. Because data integrity is crucial in the healthcare industry, this hospital should think about switching to specialized accounting systems to ensure accurate and secure financial management.

4.6 Administration Performance

Our goal in this section is to assess how well administrative assistance works when computerized accounting systems are being adopted.  Additionally, we aim to determine whether the computerized system's managerial performance evaluation has an advantage over the manual system in detecting individual performance deviations. By answering these queries, we hope to learn more about the effectiveness and efficiency of administrative procedures in light of hospital technology developments.

4.6.1Assessment of Administrative Performance in Implementing Computerized Accounting Systems

Impressions of administrative performance in putting computerized accounting systems into place are favorable, as shown in Table 6. Although there is potential for development in some areas, such as the evaluation of managerial performance, overall positive ratings point to efficient departmental coordination and administrative support during the adoption process.

4.7 Results of Hypotheses Testing