rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2025-69-5-435-441wdpdhqrfhealth-2012Research ArticleОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯHEALTH CARE ORGANIZATIONВлияние системы сбалансированных показателей на эффективность медицинских организаций: международный опыт и практические подходыThe impact of balanced scorecard on the efficiency of healthcare institutions: international experience and practical approacheshttps://orcid.org/0000-0001-8397-8327БударинаЮлия ВикторовнаBudarinaYuliya V.

Науч. сотр. отдела ценностно-ориентированного здравоохранения, ГБУ НИИОЗММ ДЗМ, 115088, Москва, Россия

e-mail: ElbekYV1@zdrav.mos.ru

Researcher, Department of the value-based healthcare, Research Institute for Healthcare Organization and Medical Management of Moscow Healthcare Department, Moscow, 115088, Russian Federation

e-mail: ElbekYV1@zdrav.mos.ru

ElbekYV1@zdrav.mos.ruГБУ города Москвы «Научно-исследовательский институт организации здравоохранения и медицинского менеджмента Департамента здравоохранения города Москвы»РоссияResearch Institute for Healthcare Organization and Medical Management of Moscow Healthcare DepartmentRussian Federation202531102025695435441Copyright © Бударина Ю.В., 20252025Бударина Ю.В.Budarina Y.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/2012Введение

Введение. Внедрение современных технологий в систему здравоохранения для обеспечения качества и доступности медицинских услуг, ориентированных на интересы и потребности пациента, подняли на новый уровень вопрос эффективности функционирования медицинских организаций и её измерения. Наиболее популярным из применяемых инструментов оценки эффективности медицинских организаций во всём мире является сбалансированная система показателей (ССП), которая позволяет учитывать различные аспекты деятельности медицинских организаций, включая финансовые, клинические, операционные и пациентоориентированные параметры.

Цель — изучение опыта применения сбалансированной системы показателей для оценки эффективности медицинских организаций в мировых странах за последние 5 лет.

Материалы и методы

Материалы и методы. Для написания статьи в качестве материала исследования использовались научные публикации, поиск которых осуществлялся на платформе Publish or Perish, а также в научной библиотеке eLIBRARY.RU по ключевым словам: balanced scorecard, BSC, medical organizations, ССП. Для анализа использовали общенаучные методы познания: сопоставление, обобщение, системно-структурный и аналитический методы.

Результаты

Результаты. Изучена практика применения ССП в различных странах. Проанализированы подходы к проведению оценки эффективности медицинских организаций на основе ССП, выявлены основные результаты и подтверждена успешность применения ССП для оценки эффективности деятельности медицинских организаций.

Ограничения исследования

Ограничения исследования. При проведении исследования были установлены следующие ограничения систематического поиска научных публикаций по тематике исследования: временны́е рамки (2020–2025 гг.), а также количество анализируемых работ, отобранных с использованием платформы Publish or Perish (Google Scholar).

Заключение

Заключение. В целом ССП является мощным инструментом для повышения эффективности медицинских организаций, но её потенциал может быть полностью раскрыт только при условии грамотного внедрения, постоянного мониторинга и адаптации к меняющимся условиям.

Соблюдение этических стандартов. Исследование одобрено Этическим комитетом по экспертизе исследований в сфере общественного здоровья, организации и социологии здравоохранения при ГБУ «НИИОЗММ ДЗМ» (протокол от 11.02.2025 № 02-01/ЭК/2025).

Финансирование

Финансирование. Данная статья подготовлена автором в рамках НИР «Разработка методологических подходов ценностно-ориентированного здравоохранения (ЦОЗ) в городе Москве» (№ по ЕГИСУ: № 123032100062-6).

Конфликт интересов

Конфликт интересов. Автор декларирует отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.

Поступила

Поступила: 04.04.2025 / Принята к печати: 24.06.2025 / Опубликована: 31.10.2025

Introduction

Introduction. The introduction of modern technologies into the healthcare system to ensure the quality and accessibility of medical services tailored to the interests and needs of the patient has raised the issue of the effectiveness of the functioning of medical organizations and its measurement to a new level. The most popular tool used to evaluate the effectiveness of medical organizations around the world is the balanced scorecard, which allows you to take into account various aspects of the activities of medical institutions, including financial, clinical, operational and patient-oriented parameters.

The purpose is to study the experience of using a system of balanced application indicators to assess the effectiveness of medical institutions in the world over the past 5 years.

Materials and methods

Materials and methods. To write the article, scientific reports were used as research material, the search for which was carried out on the Publish or Perish platform, as well as in the scientific library on the eLibrary website using the keywords: balanced scorecard, BSC, medical institutions. General scientific methods of cognition were used for the analysis: comparison, generalization, system-structural and analytical methods.

Results

Results. The practice of using SSP in various world countries has been studied. The approaches to evaluating the effectiveness of medical institutions based on SSP are analyzed, the main results are identified and the success of using SSP to evaluate the effectiveness of medical institutions is confirmed.

Research limitations

Research limitations. When conducting the study, the following limitations were established for the systematic search for scientific publications on the research topic: time frame (2020–2025), as well as the number of analyzed works selected using the Publish or Perish platform (Google Scholar.

Conclusion

Conclusion. In general, SSP is a powerful tool for improving the effectiveness of medical institutions, but its potential can be fully realized only if it is properly implemented, constantly monitored and adapted to changing conditions.

Compliance with ethical standards. Compliance with ethical standards: the study was approved by the local ethics committee of the Research Institute for Healthcare Institution and Medical Management of Moscow Healthcare Department, Moscow, protocol dated 11.02.2025 No. 02-01/ЭК/2025.

Funding

Funding. This article was prepared by the author as part of the research project «Development of methodological approaches to value-oriented healthcare (VOH) in the city of Moscow» (no. according to EGISU: 123032100062-6).

Conflict of interest

Conflict of interest. The author declares the absence of obvious and potential conflicts of interest in connection with the publication of this article.

Received

Received: April 4, 2025 / Accepted: June 24, 2025 / Published: October 31, 2025

сбалансированная система показателейклассическая модель ССПздравоохранениеоценка эффективностимедицинские организацииуправленческие решенияbalanced scorecardclassical BSC modelhealthcareperformance evaluationmedical institutionsmanagement decisionsReferencesIvanković D., Fonseca V.R., Katsapi A., Karaiskou A., Angelopoulos G., Garofil D., et al. Developing and piloting a set of quality-of-care indicators for Romanian public hospitals as part of a national programme to fund quality. BMC Health Serv. Res. 2024; 24(1): 1242. https://doi.org/10.1186/s12913-024-11462-6Ivanković D., Fonseca V.R., Katsapi A., Karaiskou A., Angelopoulos G., Garofil D., et al. Developing and piloting a set of quality-of-care indicators for Romanian public hospitals as part of a national programme to fund quality. BMC Health Serv. Res. 2024; 24(1): 1242. https://doi.org/10.1186/s12913-024-11462-6Abu Jaber A.A., Nashwan A.J. Balanced scorecard-based hospital performance measurement framework: a performance construct development approach. Cureus. 2022; 14(5): e24866. https://doi.org/10.7759/cureus.24866Abu Jaber A.A., Nashwan A.J. Balanced scorecard-based hospital performance measurement framework: a performance construct development approach. Cureus. 2022; 14(5): e24866. https://doi.org/10.7759/cureus.24866Сафаров М.А., Орехова С.В. Эффективность медицинской организации: проблемы измерения. В кн.: Сборник статей V международного научного форума. Уфа; 2023: 108–13. https://elibrary.ru/opejcjSafarov M.A., Orekhova S.V. The effectiveness of a medical organization: measurement problems. In: Collection of Articles of the V International Scientific Forum [Sbornik statei V mezhdunarodnogo nauchnogo foruma]. Ufa; 2023: 108–13. https://elibrary.ru/opejcj (in Russian)Ильин И.В., Чемерис О.С., Сарыгулов А.И. Аналитический обзор подходов к оценке эффективности функционирования медицинских организаций в условиях изменения основных бизнеспроцессов в системе здравоохранения. Наука и бизнес: пути развития. 2021; (10): 57–64. https://elibrary.ru/aaxqhbIlyin I.V., Chemeris O.S., Sarygulov A.I. Analytical review of approaches to assess the effectiveness of medical organizations in the context of main business processes changes in healthcare system. Nauka i biznes: puti razvitiya. 2021; (10): 57–64. https://elibrary.ru/aaxqhb (in Russian)Rebba V., Rizzi D. Analisi dell’efficienza relativa delle strutture di ricovero con il metodo DEA. Il caso degli ospedali del Veneto. Politiche Sanitarie. 2001; 2(1): 23–43.Rebba V., Rizzi D. Analisi dell’efficienza relativa delle strutture di ricovero con il metodo DEA. Il caso degli ospedali del Veneto. Politiche Sanitarie. 2001; 2(1): 23–43.Aghlmand S., Feizollahzadeh S., Fathi B., Yusefzadeh H., Alinejhad M. The stochastic frontier analysis technique in measuring the technical and economic efficiency of hospital diagnostic laboratories: a case study in Iran. Cost. Eff. Resour. Alloc. 2022; 20(1): 65. https://doi.org/10.1186/s12962-022-00406-8Aghlmand S., Feizollahzadeh S., Fathi B., Yusefzadeh H., Alinejhad M. The stochastic frontier analysis technique in measuring the technical and economic efficiency of hospital diagnostic laboratories: a case study in Iran. Cost. Eff. Resour. Alloc. 2022; 20(1): 65. https://doi.org/10.1186/s12962-022-00406-8Trakakis A., Nektarios M., Tziaferi S., Prezerakos P. Total productivity change of Health Centers in Greece in 2016-2018: a Malmquist index data envelopment analysis application for the primary health system of Greece. Cost. Eff. Resour. Alloc. 2021; 19(1): 72. https://doi.org/10.1186/s12962-021-00326-zTrakakis A., Nektarios M., Tziaferi S., Prezerakos P. Total productivity change of Health Centers in Greece in 2016-2018: a Malmquist index data envelopment analysis application for the primary health system of Greece. Cost. Eff. Resour. Alloc. 2021; 19(1): 72. https://doi.org/10.1186/s12962-021-00326-zKaplan R.S., Norton D.P. The balanced scorecard–measures that drive performance. Harv. Bus. Rev. 1992; 70(1): 71–9.Kaplan R.S., Norton D.P. The balanced scorecard–measures that drive performance. Harv. Bus. Rev. 1992; 70(1): 71–9.Kaplan R. Conceptual foundations of the balanced scorecard. In: Handbooks of Management Accounting Research. Volume 3. Elsevier; 2010: 1253–69. https://doi.org/10.1016/S1751-3243(07)03003-9Kaplan R. Conceptual foundations of the balanced scorecard. In: Handbooks of Management Accounting Research. Volume 3. Elsevier; 2010: 1253–69. https://doi.org/10.1016/S1751-3243(07)03003-9Speckbacher G., Bischof J., Pfeiffer T. A descriptive analysis on the implementation of balanced scorecards in German-speaking countries. Manag. Account Res. 2003; 14(4): 361–88. https://doi.org/10.1016/j.mar.2003.10.001Speckbacher G., Bischof J., Pfeiffer T. A descriptive analysis on the implementation of balanced scorecards in German-speaking countries. Manag. Account Res. 2003; 14(4): 361–88. https://doi.org/10.1016/j.mar.2003.10.001Georgiev M., Solovev D. Evolution of the concept of the Balanced Scorecard. In: 107th International Scientific Conference on Economic and Social Development — Economic and Social Survival in Global Changes. Zagreb; 2024: 83–93. https://doi.org/10.2139/ssrn.4772748Georgiev M., Solovev D. Evolution of the concept of the Balanced Scorecard. In: 107th International Scientific Conference on Economic and Social Development — Economic and Social Survival in Global Changes. Zagreb; 2024: 83–93. https://doi.org/10.2139/ssrn.4772748de Almeida Marques P.C., Oliveira P.A.A.T.F., de Santana Porte M. Bibliometric analysis – what has been studied about balanced scorecard? Revista de Gestão e Secretariado. 2024; 15(9): e4069. https://doi.org/10.7769/gesec.v15i9.4069de Almeida Marques P.C., Oliveira P.A.A.T.F., de Santana Porte M. Bibliometric analysis – what has been studied about balanced scorecard? Revista de Gestão e Secretariado. 2024; 15(9): e4069. https://doi.org/10.7769/gesec.v15i9.4069Kumar S., Lim W.M., Sureka R., Jabbour C.J.C., Bamel U. Balanced scorecard: trends, developments, and future directions. Rev. Manag. Sci. 2024; 18: 2397–439. https://doi.org/10.1007/s11846-023-00700-6Kumar S., Lim W.M., Sureka R., Jabbour C.J.C., Bamel U. Balanced scorecard: trends, developments, and future directions. Rev. Manag. Sci. 2024; 18: 2397–439. https://doi.org/10.1007/s11846-023-00700-6Roselló-Calzada T., Ribas-Vila I., Caro-Benito C. Suitability of referenced models for designing balanced scorecards in Healthcare Organizations. J. Ind. Eng. Manag. 2025; 18(1): 33–47. https://doi.org/10.3926/jiem.6793Roselló-Calzada T., Ribas-Vila I., Caro-Benito C. Suitability of referenced models for designing balanced scorecards in Healthcare Organizations. J. Ind. Eng. Manag. 2025; 18(1): 33–47. https://doi.org/10.3926/jiem.6793Tawse A., Tabesh P. Thirty years with the balanced scorecard: What we have learned. Business Horizons. 2023; 66(1): 123–32. https://doi.org/10.1016/j.bushor.2022.03.005Tawse A., Tabesh P. Thirty years with the balanced scorecard: What we have learned. Business Horizons. 2023; 66(1): 123–32. https://doi.org/10.1016/j.bushor.2022.03.005Zhang L., Liu R., Jiang S., Luo G., Liu H.C. Identification of key performance indicators for hospital management using an extended hesitant linguistic DEMATEL approach. Healthcare (Basel). 2019; 8(1): 7. https://doi.org/10.3390/healthcare8010007Zhang L., Liu R., Jiang S., Luo G., Liu H.C. Identification of key performance indicators for hospital management using an extended hesitant linguistic DEMATEL approach. Healthcare (Basel). 2019; 8(1): 7. https://doi.org/10.3390/healthcare8010007Wang S.W., De Leon J.M. Establishment of performance evaluation system for public hospitals – based on balanced scorecard. Highlights in science. Eng. Technol. 2023; 45: 81–4. https://doi.org/10.54097/hset.v45i.7313Wang S.W., De Leon J.M. Establishment of performance evaluation system for public hospitals – based on balanced scorecard. Highlights in science. Eng. Technol. 2023; 45: 81–4. https://doi.org/10.54097/hset.v45i.7313Koumpouros Y. Balanced scorecard: application in the general Panarcadian Hospital of Tripolis, Greece. Int. J. Health Care Qual. Assur. 2013; 26(4): 286–307. https://doi.org/10.1108/09526861311319546Koumpouros Y. Balanced scorecard: application in the general Panarcadian Hospital of Tripolis, Greece. Int. J. Health Care Qual. Assur. 2013; 26(4): 286–307. https://doi.org/10.1108/09526861311319546Widyasari N.L.G., Adi N.R. Balanced scorecard implementation in the government hospital. Russ. J. Agric. Soc. Econ. Sci. 2019; 9(93): 285–91. https://doi.org/10.18551/rjoas.2019-09.30Widyasari N.L.G., Adi N.R. Balanced scorecard implementation in the government hospital. Russ. J. Agric. Soc. Econ. Sci. 2019; 9(93): 285–91. https://doi.org/10.18551/rjoas.2019-09.30Smith C., Christiansen T., Dick D., Howden J.S., Wasylak T., Werle J. Performance management tools motivate change at the frontlines. Healthc. Manage. Forum. 2014; 27(1): 15–9. https://doi.org/10.1016/j.hcmf.2013.12.003Smith C., Christiansen T., Dick D., Howden J.S., Wasylak T., Werle J. Performance management tools motivate change at the frontlines. Healthc. Manage. Forum. 2014; 27(1): 15–9. https://doi.org/10.1016/j.hcmf.2013.12.003Catuogno 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. 2017; 17(1): 522. https://doi.org/10.1186/s12913-017-2479-6Catuogno 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. 2017; 17(1): 522. https://doi.org/10.1186/s12913-017-2479-6Lin C.Y., Shih F.C., Ho Y.H. Applying the balanced scorecard to build service performance measurements of medical institutions: an ahp-dematel approach AHP-DEMATEL approach. Int. J. Environ. Res. Public Health. 2023; 20(2): 1022. https://doi.org/10.3390/ijerph20021022Lin C.Y., Shih F.C., Ho Y.H. Applying the balanced scorecard to build service performance measurements of medical institutions: an ahp-dematel approach AHP-DEMATEL approach. Int. J. Environ. Res. Public Health. 2023; 20(2): 1022. https://doi.org/10.3390/ijerph20021022Bassani G., Leardini C., Campedelli B., Moggi S. The dynamic use of a balanced scorecard in an Italian public hospital. Int. J. Health Plann. Manage. 2022; 37(3): 1781–98. https://doi.org/10.1002/hpm.3440Bassani G., Leardini C., Campedelli B., Moggi S. The dynamic use of a balanced scorecard in an Italian public hospital. Int. J. Health Plann. Manage. 2022; 37(3): 1781–98. https://doi.org/10.1002/hpm.3440Guo F., Huang Y.S., Nemoto M. Reimagining hospital management: the balanced scorecard as a catalyst for employee retention and organizational excellence. Front. Public Health. 2024; 12: 1485683. https://doi.org/10.3389/fpubh.2024.1485683Guo F., Huang Y.S., Nemoto M. Reimagining hospital management: the balanced scorecard as a catalyst for employee retention and organizational excellence. Front. Public Health. 2024; 12: 1485683. https://doi.org/10.3389/fpubh.2024.1485683Hafianti R., Lestari Y., Erlinengsih E. Measuring performance of Padang Panjang Public Hospital in achieving its targets using the balanced scorecard method. Media Kesehatan Masyarakat Indonesia. 2022; 18(2): 74–82. https://doi.org/10.30597/mkmi.v18i2.19006Hafianti R., Lestari Y., Erlinengsih E. Measuring performance of Padang Panjang Public Hospital in achieving its targets using the balanced scorecard method. Media Kesehatan Masyarakat Indonesia. 2022; 18(2): 74–82. https://doi.org/10.30597/mkmi.v18i2.19006Nafari E., Rezaei B. Relationship between human resources strategies and organizational performance based on the balanced scorecard in a public hospital in Iran: a cross-sectional study. BMC Health Serv. Res. 2022; 22(1): 363. https://doi.org/10.1186/s12913-022-07767-zNafari E., Rezaei B. Relationship between human resources strategies and organizational performance based on the balanced scorecard in a public hospital in Iran: a cross-sectional study. BMC Health Serv. Res. 2022; 22(1): 363. https://doi.org/10.1186/s12913-022-07767-zWalangadi Z. Performance insights of Puskesmas Tilango through the balanced scorecard approach. J. Ners. 2024; 9(1): 632–51. https://doi.org/10.31004/jn.v9i1.19753Walangadi Z. Performance insights of Puskesmas Tilango through the balanced scorecard approach. J. Ners. 2024; 9(1): 632–51. https://doi.org/10.31004/jn.v9i1.19753Pham C.D., Vu S.T., Pham Y.T K., Vu N.T. Evaluating performance of vietnamese public hospitals based on balanced scorecard. J. Asian Finance Econ. Bus. 2020; 7(6): 339–49. https://doi.org/10.13106/jafeb.2020.vol7.no6.339Pham C.D., Vu S.T., Pham Y.T K., Vu N.T. Evaluating performance of vietnamese public hospitals based on balanced scorecard. J. Asian Finance Econ. Bus. 2020; 7(6): 339–49. https://doi.org/10.13106/jafeb.2020.vol7.no6.339Ben Fradj A., El Asli N., Boukherroub T., Olivier C. Developing an integrated performance management and measurement system in healthcare organisations: a Canadian case study. F1000Research. 2023; 12: 1420. https://doi.org/10.12688/f1000research.138430.1Ben Fradj A., El Asli N., Boukherroub T., Olivier C. Developing an integrated performance management and measurement system in healthcare organisations: a Canadian case study. F1000Research. 2023; 12: 1420. https://doi.org/10.12688/f1000research.138430.1Olariu A.A., Popa S.C., Breazu A., Popa C.F. Organizational performance in the public and private sectors in Romania: the balanced scorecard perspective. Manag. Res. Pract. 2023; 15(2): 17–28.Olariu A.A., Popa S.C., Breazu A., Popa C.F. Organizational performance in the public and private sectors in Romania: the balanced scorecard perspective. Manag. Res. Pract. 2023; 15(2): 17–28.

The authors declare that there are no conflicts of interest present.