Abstract
This article analyzes the interplay of the use of management control systems, organizational learning, management decisions and the performance of health organizations. In the quantitative step, we collected data on 48 Brazilian hospitals and other health facilities by means of a survey. Principal component analysis identified three dimensions of management decisions (financial, costs and client relationship) and two performance dimensions (economic and non-monetary). Structural equation modeling confirmed the following hypotheses: (i) interactive use of the management control system is positively associated with organizational learning (OL); (ii) OL is positively associated with financial decisions and cost and process decisions; (iii) cost and process decisions and decisions related to clients are positively associated with economic performance; and (iv) cost and process decisions are also positively associated with non-monetary performance. In the qualitative step, we interviewed four key informants to discuss and interpret the results.
Highlights
This article analyzes the interplay of the use of management control systems, organizational learning, management decisions and the performance of health organizations
Private Brazilian hospitals and other health facilities are strongly dependent on reimbursements from the National Health System (SUS), which are often slow in coming due to budget deficits
In this article we focus on organizational learning, which is an organizational competency characterized by the way organizations acquire and internally disseminate new knowledge (CHENHALL, 2005)
Summary
This article analyzes the interplay of the use of management control systems, organizational learning, management decisions and the performance of health organizations. 1 INTRODUCTION his paper investigates relationships among management control system use, Torganizational learning, management decisions and performance of organizations This theme is relevant because health organizations have highly complex processes: services, organizational structures, diversification of professionals and technologies applied to protect people’s health (NOVAES, 2004). This panorama involves a set of categories that makes it difficult to identify, measure and analyze the individual impacts of these aspects on performance of these organizations. Private Brazilian hospitals and other health facilities are strongly dependent on reimbursements from the National Health System (SUS), which are often slow in coming due to budget deficits Another aggravating factor is the low prices for services paid by private health plan operators and insurers (CREMESP, 2006; IBGE, 2008). The diversity of the organizations acting in the sector creates extreme situations in terms of performance, because there are both charitable and for-profit organizations (GADELHA, 2003)
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