Performance management and measurement— concepts for better management control in public hospitals? A study of the hospital sector in Norway

This paper investigates the link between performance measures and decision-making processes in the Norwegian hospital sector. The research findings are expected to add knowledge to the implementation of performance measurements and management systems in this context. The implementation of performance-based management systems acts as an element of reform that is similar to the New Public Management reform wave affecting the hospital sector internationally. The empirical study is based on surveys at the national level, structured interviews in a large university hospital department, and statistics gathered from the accounting system at the clinical department level. A major conclusion is that the standard unit cost per patient, which is important benchmarking data, does not give relevant information for decisions in the hospital. Furthermore, the crudeness in the input and output measures hampers the implementation of performance management in health care institutions.