The use of the performance measures in Thai public hospitals

Purpose - The purpose of this paper is to examine the relationships between participation in performance measurement systems (PMS) and the use of performance measures; the use of performance measures and managerial performance; and participation in PMS and managerial performance in public hospitals in Thailand. Design/methodology/approach - Data were collected using a mailed questionnaire. A total of 304 middle managers in public hospitals in Southern Thailand participated in the study. The data were analyzed using structural equation modeling. Findings - The results reveal a positive relationship between participation in PMS and the use of performance measures, and a positive relationship between the use of performance measures and managerial performance. The results also indicate a positive relationship between participation in PMS and improved managerial performance. Practical implications - Results indicate that top managers in hospitals should allow middle managers to have greater participation in their organization’s PMS. By sharing information between top and middle managers, a PMS can be developed that reflects the organization’s goals, as well as being suitable for departmental performance evaluation. This enhances PMS acceptance by middle managers, and reduces task ambiguity, leading to improved managerial performance. Originality/value - As middle managers participate more in PMS, their acceptance of PMS increases. They then make greater use of both financial and non-financial performance measures to obtain comprehensive feedback about their department’s performance. This enhances their decision outcomes, resulting in improved managerial performance.