The public sector performance management (PM) literature is particularly rich as this topic is one of the most appealing for public sector scholars (Pollitt, J Public Adm Res Theory 6:25-44, 2005). However, organizational performance (OP) has been neglected across the world (Andrews et al. J Public Adm Res Theory 21:i301-i319, 2011) as well as in the Italian public administration (Martin and Spano, Public Money Manag 35:303-310, 2015). This chapter investigates how OP is defined, measured, and evaluated in the Italian health care sector. Our analysis showed the limited use of performance management in Italian public health organizations and a high variability in the way OP is defined and measured. This makes it difficult to compare the results of different organizations. For this reason, future standardization could allow policy makers to improve the accountability.Keywords Organizational performance Á Health care Á Italian public sector
IntroductionThe issue of OP is of particular relevance in the healthcare sector, where the impact of health organizations on individuals' lives is significant and measures of OP are required to understand the extent to which these organizations are effective. Even though significant progress has been made in building more advanced performance measurement systems in the health care sector, more work is needed (Smith et al. 2008). In fact, the literature on performance management in the health care sector reports several cases of incorrect uses and, even misuses of performance measures and targets with the introduction of a kind of "governance by targets" and a Traditionally, performance in health care has been measured using specific indicators such as incidence of pathology, mortality measures, and measures of mortality after a specific treatment. Other measures are increasingly attractive, including those that focus on patient health status, which are often in the form of outcome measures (Smith et al. 2008). However, there is a limited "understanding of how performance measurement can be organized to support improvement initiatives in health care practices" (Elg et al. 2013).In the Italian public sector, the role of OP has been largely neglected, and more importance has been given to individual performance (Martin and Spano 2015). As far as the healthcare sector is concerned, OP is attracting increased attention in Italy, but there is still a lack of extensive research on this topic. For example, there is a high variation in the way OP is defined and, consequently, measured. In particular, a comprehensive analysis of the current OP practices as measured by Italian health care organizations is still missing. For this reason, our research aims at addressing the following research questions (RQs):RQ1: How do Italian health care organizations define OP? RQ2: Is OP measured by Italian health care organizations, and if so, how?This chapter is organized into six sections: (1) literature review on OP with specific reference to the health care sector; (2) the Italian health ...