The impact of balanced scorecard on the efficiency of healthcare institutions: international experience and practical approaches

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Abstract

Introduction. The introduction of modern technologies into the healthcare system to ensure the quality and accessibility of medical services tailored to the interests and needs of the patient has raised the issue of the effectiveness of the functioning of medical organizations and its measurement to a new level. The most popular tool used to evaluate the effectiveness of medical organizations around the world is the balanced scorecard, which allows you to take into account various aspects of the activities of medical institutions, including financial, clinical, operational and patient-oriented parameters.The purpose is to study the experience of using a system of balanced application indicators to assess the effectiveness of medical institutions in the world over the past 5 years.Materials and methods. To write the article, scientific reports were used as research material, the search for which was carried out on the Publish or Perish platform, as well as in the scientific library on the eLibrary website using the keywords: balanced scorecard, BSC, medical institutions. General scientific methods of cognition were used for the analysis: comparison, generalization, system-structural and analytical methods.Results. The practice of using SSP in various world countries has been studied. The approaches to evaluating the effectiveness of medical institutions based on SSP are analyzed, the main results are identified and the success of using SSP to evaluate the effectiveness of medical institutions is confirmed.Research limitations. When conducting the study, the following limitations were established for the systematic search for scientific publications on the research topic: time frame (2020–2025), as well as the number of analyzed works selected using the Publish or Perish platform (Google Scholar.Conclusion. In general, SSP is a powerful tool for improving the effectiveness of medical institutions, but its potential can be fully realized only if it is properly implemented, constantly monitored and adapted to changing conditions.Compliance with ethical standards. Compliance with ethical standards: the study was approved by the local ethics committee of the Research Institute for Healthcare Institution and Medical Management of Moscow Healthcare Department, Moscow, protocol dated 11.02.2025 No. 02-01/ЭК/2025.Funding. This article was prepared by the author as part of the research project «Development of methodological approaches to value-oriented healthcare (VOH) in the city of Moscow» (no. according to EGISU: 123032100062-6).Conflict of interest. The author declares the absence of obvious and potential conflicts of interest in connection with the publication of this article.Received: April 4, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

About the authors

Yuliya V. Budarina

Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department

Email: ElbekYV1@zdrav.mos.ru
ORCID iD: 0000-0001-8397-8327

References

  1. Ivanković D., Fonseca V.R., Katsapi A., Karaiskou A., Angelopoulos G., Garofil D., et al. Developing and piloting a set of quality-of-care indicators for Romanian public hospitals as part of a national programme to fund quality. BMC Health Serv. Res. 2024; 24(1): 1242. https://doi.org/10.1186/s12913-024-11462-6
  2. Abu Jaber A.A., Nashwan A.J. Balanced scorecard-based hospital performance measurement framework: a performance construct development approach. Cureus. 2022; 14(5): e24866. https://doi.org/10.7759/cureus.24866
  3. Сафаров М.А., Орехова С.В. Эффективность медицинской организации: проблемы измерения. В кн.: Сборник статей V международного научного форума. Уфа; 2023: 108–13. https://elibrary.ru/opejcj
  4. Ильин И.В., Чемерис О.С., Сарыгулов А.И. Аналитический обзор подходов к оценке эффективности функционирования медицинских организаций в условиях изменения основных бизнеспроцессов в системе здравоохранения. Наука и бизнес: пути развития. 2021; (10): 57–64. https://elibrary.ru/aaxqhb
  5. Rebba V., Rizzi D. Analisi dell’efficienza relativa delle strutture di ricovero con il metodo DEA. Il caso degli ospedali del Veneto. Politiche Sanitarie. 2001; 2(1): 23–43.
  6. Aghlmand S., Feizollahzadeh S., Fathi B., Yusefzadeh H., Alinejhad M. The stochastic frontier analysis technique in measuring the technical and economic efficiency of hospital diagnostic laboratories: a case study in Iran. Cost. Eff. Resour. Alloc. 2022; 20(1): 65. https://doi.org/10.1186/s12962-022-00406-8
  7. Trakakis A., Nektarios M., Tziaferi S., Prezerakos P. Total productivity change of Health Centers in Greece in 2016-2018: a Malmquist index data envelopment analysis application for the primary health system of Greece. Cost. Eff. Resour. Alloc. 2021; 19(1): 72. https://doi.org/10.1186/s12962-021-00326-z
  8. Kaplan R.S., Norton D.P. The balanced scorecard–measures that drive performance. Harv. Bus. Rev. 1992; 70(1): 71–9.
  9. Kaplan R. Conceptual foundations of the balanced scorecard. In: Handbooks of Management Accounting Research. Volume 3. Elsevier; 2010: 1253–69. https://doi.org/10.1016/S1751-3243(07)03003-9
  10. Speckbacher G., Bischof J., Pfeiffer T. A descriptive analysis on the implementation of balanced scorecards in German-speaking countries. Manag. Account Res. 2003; 14(4): 361–88. https://doi.org/10.1016/j.mar.2003.10.001
  11. Georgiev M., Solovev D. Evolution of the concept of the Balanced Scorecard. In: 107th International Scientific Conference on Economic and Social Development — Economic and Social Survival in Global Changes. Zagreb; 2024: 83–93. https://doi.org/10.2139/ssrn.4772748
  12. de Almeida Marques P.C., Oliveira P.A.A.T.F., de Santana Porte M. Bibliometric analysis – what has been studied about balanced scorecard? Revista de Gestão e Secretariado. 2024; 15(9): e4069. https://doi.org/10.7769/gesec.v15i9.4069
  13. Kumar S., Lim W.M., Sureka R., Jabbour C.J.C., Bamel U. Balanced scorecard: trends, developments, and future directions. Rev. Manag. Sci. 2024; 18: 2397–439. https://doi.org/10.1007/s11846-023-00700-6
  14. Roselló-Calzada T., Ribas-Vila I., Caro-Benito C. Suitability of referenced models for designing balanced scorecards in Healthcare Organizations. J. Ind. Eng. Manag. 2025; 18(1): 33–47. https://doi.org/10.3926/jiem.6793
  15. Tawse A., Tabesh P. Thirty years with the balanced scorecard: What we have learned. Business Horizons. 2023; 66(1): 123–32. https://doi.org/10.1016/j.bushor.2022.03.005
  16. Zhang L., Liu R., Jiang S., Luo G., Liu H.C. Identification of key performance indicators for hospital management using an extended hesitant linguistic DEMATEL approach. Healthcare (Basel). 2019; 8(1): 7. https://doi.org/10.3390/healthcare8010007
  17. Wang S.W., De Leon J.M. Establishment of performance evaluation system for public hospitals – based on balanced scorecard. Highlights in science. Eng. Technol. 2023; 45: 81–4. https://doi.org/10.54097/hset.v45i.7313
  18. Koumpouros Y. Balanced scorecard: application in the general Panarcadian Hospital of Tripolis, Greece. Int. J. Health Care Qual. Assur. 2013; 26(4): 286–307. https://doi.org/10.1108/09526861311319546
  19. Widyasari N.L.G., Adi N.R. Balanced scorecard implementation in the government hospital. Russ. J. Agric. Soc. Econ. Sci. 2019; 9(93): 285–91. https://doi.org/10.18551/rjoas.2019-09.30
  20. Smith C., Christiansen T., Dick D., Howden J.S., Wasylak T., Werle J. Performance management tools motivate change at the frontlines. Healthc. Manage. Forum. 2014; 27(1): 15–9. https://doi.org/10.1016/j.hcmf.2013.12.003
  21. Catuogno S., Arena C., Saggese S., Sarto F. Balanced performance measurement in research hospitals: the participative case study of a haematology department. BMC Health Serv. Res. 2017; 17(1): 522. https://doi.org/10.1186/s12913-017-2479-6
  22. Lin C.Y., Shih F.C., Ho Y.H. Applying the balanced scorecard to build service performance measurements of medical institutions: an ahp-dematel approach AHP-DEMATEL approach. Int. J. Environ. Res. Public Health. 2023; 20(2): 1022. https://doi.org/10.3390/ijerph20021022
  23. Bassani G., Leardini C., Campedelli B., Moggi S. The dynamic use of a balanced scorecard in an Italian public hospital. Int. J. Health Plann. Manage. 2022; 37(3): 1781–98. https://doi.org/10.1002/hpm.3440
  24. Guo F., Huang Y.S., Nemoto M. Reimagining hospital management: the balanced scorecard as a catalyst for employee retention and organizational excellence. Front. Public Health. 2024; 12: 1485683. https://doi.org/10.3389/fpubh.2024.1485683
  25. Hafianti R., Lestari Y., Erlinengsih E. Measuring performance of Padang Panjang Public Hospital in achieving its targets using the balanced scorecard method. Media Kesehatan Masyarakat Indonesia. 2022; 18(2): 74–82. https://doi.org/10.30597/mkmi.v18i2.19006
  26. Nafari E., Rezaei B. Relationship between human resources strategies and organizational performance based on the balanced scorecard in a public hospital in Iran: a cross-sectional study. BMC Health Serv. Res. 2022; 22(1): 363. https://doi.org/10.1186/s12913-022-07767-z
  27. Walangadi Z. Performance insights of Puskesmas Tilango through the balanced scorecard approach. J. Ners. 2024; 9(1): 632–51. https://doi.org/10.31004/jn.v9i1.19753
  28. Pham C.D., Vu S.T., Pham Y.T K., Vu N.T. Evaluating performance of vietnamese public hospitals based on balanced scorecard. J. Asian Finance Econ. Bus. 2020; 7(6): 339–49. https://doi.org/10.13106/jafeb.2020.vol7.no6.339
  29. Ben Fradj A., El Asli N., Boukherroub T., Olivier C. Developing an integrated performance management and measurement system in healthcare organisations: a Canadian case study. F1000Research. 2023; 12: 1420. https://doi.org/10.12688/f1000research.138430.1
  30. Olariu A.A., Popa S.C., Breazu A., Popa C.F. Organizational performance in the public and private sectors in Romania: the balanced scorecard perspective. Manag. Res. Pract. 2023; 15(2): 17–28.

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