The Balance Scorecard Implementation in the Italian Health Care System

Abstract

In the last few years, in the healthcare organizations, it has become crucial not only to manage the costs, but also to understand the relationship between quality and cost. Indeed, a variety of stakeholder groups are putting increasing pressure on providers for measured performance; they are demanding data on quality and patient satisfaction, although simultaneously pressing for lower costs (Griffith and King 2000). It is clear how the balanced scorecard is (BSC) important to manage, strategically, the quality and the costs in the health care system, but it is also important to underline that this tool has to be adapted to these kinds of organizations among its classical use. Consequently, the main goals of this article are: (a) to make a complete literature review of the papers with case studies published on the topic of BSC in Italian health care system during the period 1992–2012, using international databases to understand the use of this strategic management tool; and (b) to conduct an empirical analysis based on an Italian hospital case study, with particular attention to the BSC adoption, to understand the connected issues of the use of this tool. By this analysis, it emerges that there is a gap in the literature of empirical case studies, so the case study analyzed contributes to fill this gap. Further research can include the comparison of the Italian situation with other foreign countries.