Public Hospitals Performance. Theoretical Foundations and Challenges

Public hospitals performance is currently a public management subject of great interest. On the one hand, there is the pressure of the State and of the taxpayer (health insurance payer), which have expectations regarding the capitalisation of health expenditures. On the other hand, there is the pressure put by users, as consumers, who want to have the power to choose in a field they consider essential for their state of health. In these circumstances, the following questions arise: How do public hospitals see performance? Do they consider this performance requirement a threat, in the context of public and private sector competition, or do they see it as a real opportunity to improve the quality of the services provided to users (patients) and ensure an efficient State governance (as the State is the one financing public health services)? Our article aims at answering these questions, which represent major challenges for a national health system.