Hospital Performance Assessment Balanced Scorecard Method – Its Implementation in the Third Decade: Scoping Review



  • Lasma Frisca Yoselina Panjaitan Program Magister Kajian Administrasi Rumah Sakit, Fakultas Kesehatan Masyarakat, Universitas Indonesia
  • Amal Chalik Sjaaf Departemen Administrasi Kebijakan Kesehatan, Fakultas Kesehatan Masyarakat, Universitas Indonesia
  • Roza Falinda Program Magister Kajian Administrasi Rumah Sakit, Fakultas Kesehatan Masyarakat, Universitas Indonesia



Balanced Scorecard, Rumah sakitah Sakit, kinerja


Background : Balanced score card (BSC) has been for decades  used as a performance measurement tool in many healthcare setting including hospital. Hospital performance measurement is essential to gauge, spesifically during the covid-19 pandemic where many hospitals are experiencing difficulties to sustain. Balanced  Scorecard  (BSC) is one of the widely used method to improve hospital performance for it’s comprehensiveness. The method applied four perspectives, those are financial perspective, growth and learning, custumor, and internal process. The aim of this study is to review the development of BSC implementation in hospitals across the globe in the 3rd decade, and the benefit to implement in local hospitals.

Method : Research method is scoping review. The search manually started by studying related articles. Key words used to search articles are  Hospital Performance  and Balanced Scorecard, hospital performance measurement through data base EMBASE, MEDLINE and PuBMed.

Result : 400 records were identified and 23 underwent a full text review. 10 articles were included.  BSC in hospital setting has developed, not only as a performance evaluation tool but also to drive performance by integrating BSC as mapping strategy. This study shows that most hospitals still adapt the 2nd  generation of BSC,  mapping strategy.  Only one hospital performed the destination statement. A few of which applies it as a tool to measure performance

Conclusion : BSC has been implemented as performance management tool in hospitals worldwide. There have been  improvements in the 3rd decade, its not only for monitoring performance as mapping strategy to approach hospital’s goals..


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Bohm V, Lacaille D, Spencer N, Barber CEH. Scoping review of balanced scorecards for use in healthcare settings: development and implementation. BMJ open Qual [Internet]. 2021;10(3):2021.

Niven PR. Balanced Scorecard Evolution-A Dynamic Approach to Strategy Execution. New Jersey: John Wiley & Sons, Inc., Hoboken; 2014.

Perkins M, Grey A, Remmers H. What do we really mean by “Balanced Scorecard”? Int J Product Perform Manag [Internet]. 2014;63(2):148–69. Available from:

Abdel-Kader M, Moufty S, Laitinen EK. Balanced Scorecard Development: A Review of Literature and Directions for Future Research. Rev Manag Account Res. 2011;214–39.

Kaplan RS, Norton DP. The balanced scorecard--measures that drive performance. Harv Bus Rev. 1992;70(1):71–9.

Kaplan, R.S., and Norton D. Putting the balanced scorecard to work, The Economic Impact of Knowledge. 1993. 315–324 p.

Akbarzadeh F. The Balanced Scorecard ( BSC ) Method : From Theory to Practice. Oman Chapter Arab J Bus Manag Rev. 2012;2(5):88–98.

Elisabeth DM. Tinjauan Pustaka Balanced Scorecard, Keunggulan Dan Kelemahan Penerapan Balanced Scorecard. Methosika J Akunt dan Keuang Methodist. 2018 Apr 5;1(2):96–107.

Alipour F, Jamshidizadeh S, Bastani P, Mehralian G. The balanced scorecard as a strategic management tool in hospital pharmacies: an experimental study. J Health Organ Manag [Internet]. 2022 May 31;ahead-of-p(ahead-of-print).:

Zanini MT. The Balanced Scorecard: Evolution to long-term performance [Internet]. ProQuest Dissertations and Theses. [Ann Arbor]: University of Nevada, Reno; 2003. Available from:

Kaplan, Robert S; Norton DP. Translating Strategy into Action The Balance Score card [Internet]. 1996. 1–401 p.:

Amer F, Hammoud S, Khatatbeh H, Lohner S, Boncz I, Endrei D. The deployment of balanced scorecard in health care organizations: is it beneficial? A systematic review. BMC Health Serv Res [Internet]. 2022 Jan 10;22(1):65.:

Kaplan.R.S, & Norton DP. “Strategic Maps”, Strategic Finance. Harv Bus Rev. 2004;85(9):27–35.

Kaplan.R.S, & Norton DP. How to implement a new strategy without disruping your organization. Harv Bus Rev. 2006;84(3):100.

Apa Fungsi Balanced Scorecard dari Generasi Pertama Sampai Keempat? [Internet]. [cited 2022 Jun 7]. Available from:

Waskito HH, Agustina L. Penerapan Balance Scorecard Sebagai Tolok Ukur Kinerja Pada Rsud Kota Semarang. Account Anal J. 2015;4(1):1–13.

Parmita R. Analisis Pengukuran Kinerja Rumah Sakit dengan Pendekatan balanced Scorecard pada Rumah Sakit Daerah Madani Palu. Katalogis. 2001;3(5):143–53.

Suwandewi KS, Zukhri A, Dunia IK, Ekonomi JP, Ekonomi F. Analisis Balanced Scorecard Sebagai Media Penilaian Kinerja Pada Rumah Sakit Umum Shanti Graha Tahun 2012. 2012;

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372.

Behrouzi F, Ma’aram A. Identification and ranking of specific balanced scorecard performance measures for hospitals: A case study of private hospitals in the Klang Identification and ranking of specific balanced scorecard performance measures for hospitals: A case study of priv. Int J Health Plann Manage [Internet]. 2019;34(4):1364–76. Available from:

Raeisi AR, Yarmohammadian MH, Bakhsh RM, Gangi H. Performance evaluation of Al-Zahra academic medical center based on Iran balanced scorecard model. J Educ Health Promot. 2012;1:1.

Gao T, Gurd B. Meeting the challenge in performance management: the diffusion and implementation of the balanced scorecard in Chinese hospitals. Health Policy Plan [Internet]. 2015;30(2):234–41.

Gao H, Chen H, Feng J, Qin X, Wang X, Liang S, et al. Balanced scorecard-based performance evaluation of Chinese county hospitals in underdeveloped areas. J Int Med Res [Internet]. 2018 May;46(5):1947–62. Available from:

Koumpouros Y. Balanced scorecard: Application in the General Panarcadian Hospital of Tripolis, Greece. Int J Health Care Qual Assur [Internet]. 2013;26(4):286–307. Available from:

Chen HF, Hou YH, Chang RE. Application of the balanced scorecard to an academic medical center in Taiwan: The effect of warning systems on improvement of hospital performance. J Chinese Med Assoc. 2012;75(10):530–5.

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 [Internet]. 2017 Aug 3 [cited 2022 Apr 25];17(1):522.:

Oliveira HC, Rodrigues LL, Craig R. Bureaucracy and the balanced scorecard in health care settings. Int J Health Care Qual Assur. 2020;33(3):247–59.

Yang CH, Lee KC. Developing a strategy map for forensic accounting with fraud risk management: An integrated balanced scorecard-based decision model. Eval Program Plann [Internet]. 2020 Jun;80:101780. Available from:

Bassani G, Leardini C, Campedelli B, Moggi S. The dynamic use of a balanced scorecard in an Italian public hospital. Int J Heal Plann Mgmt. 2022;37:1781–98.

Aujirapongpan S, Meesook K, Theinsathid P, Maneechot C. Performance Evaluation of Community Hospitals in Thailand: An Analysis Based on the Balanced Scorecard Concept. Iran J Public Health [Internet]. 2020 May;49(5):906–13. Available from:

Rahimi H, Bahmaei J, Shojaei P, Kavosi Z, Khavasi M. Developing a strategy map to improve public hospitals performance with balanced scorecard and dematel approach. Shiraz E Med J [Internet]. 2018;19(7). Available from:

Amer F, Hammoud S, Khatatbeh H, Lohner S, Boncz I, Endrei D. A Systematic Review: The Dimensions utilized in the Performance Evaluation of Healthcare- An Implication during the COVID-19 Pandemic [Internet]. medRxiv. Faculty of Health Sciences, University of Pécs, Pécs, Hungary; 2021.

Rouis S, Ben Abdelaziz A, Nouira H, Khelil M, Zoghlami C, Ben Abdelaziz A. Development of a Balanced Scorecard for the monitoring of hospital performance in the countries of the Greater Maghreb. Systematic Review. Tunis Med [Internet]. 2018 Oct;96(10–11):774–88.:








How to Cite

Panjaitan LFY, Sjaaf AC, Falinda R. Hospital Performance Assessment Balanced Scorecard Method – Its Implementation in the Third Decade: Scoping Review: -. J Keskom [Internet]. 2023 Jan. 2 [cited 2023 Mar. 21];8(3):586-9. Available from: