Performance Measurement Systems Innovations in National Healthcare Contexts

The present study aims to understand the role played by cultural, institutional and organisational factors in affecting performance measurement system (PMS) dynamics and innovations in public healthcare settings. We analyse PMSs dynamics and innovations in public healthcare relying on Leotta and Ruggeri’s (2012) contribution which integrates the Busco et al.’s (2007) framework with the perspectives from Neo-Institutional Sociology (NIS) and Old-Institutional Economics (OIE). Two interpretive longitudinal case studies are conducted. The Italian case refers to a large teaching hospital, aimed at interpreting PMS changes along the period from 1998 until 2003.The Japanese case refers, instead, to a general hospital. Italian and Japanese public healthcare contexts have some significant similarities, since both societies have been rapidly ageing and are two of the most aged societies in the world, requiring adequate and sustainable healthcare systems. This paper tries to explore how the two countries have faced similar characteristics which are different from Anglo-Saxon experiences; at the same time, how Italy and Japan have developed different solutions for similar issues in healthcare contexts. Results show the institutionalisation process in both hospitals, how the notion of control is specifically developed in both countries, reflecting the institutional context and the reasons behind the public reforms.