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Performance measurement systems in the health and care sector: are targets and monitoring additional demands or resources for employees?

de Menezes, L. M. ORCID: 0000-0001-9155-5850 & Escrig-Tena, A. B. (2023). Performance measurement systems in the health and care sector: are targets and monitoring additional demands or resources for employees?. International Journal of Operations and Production Management, 43(13), pp. 302-329. doi: 10.1108/IJOPM-12-2022-0763


Purpose: This paper aims to improve our understanding of performance measurement systems in the health and care sector, by focusing on employee reactions to core performance measurement practices. Targets and monitoring are hypothesised to be associated with employee-perceptions of job control, supportive management, and job demands, which in turn, are expected to be linked to employee-wellbeing and organisational commitment.

Methodology: Matched employee-workplace data are extracted from a nationally representative and publicly available survey. Structural equation models are estimated.

Findings: Performance measurement systems are neither perceived as resources nor additional demands. Setting many targets and a focus on productivity can lead to negative employeeoutcomes, since these positively correlate with perceptions of job demands, which negatively correlate with employee-wellbeing. However, monitoring financial performance and monitoring employee-performance may be helpful to managers, as these are positively associated with employee-perceptions of job control and supportive management, which positively correlate with job satisfaction and organisational commitment and, negatively, with anxiety. Overall, common criticisms of performance measurement systems in healthcare are questioned.

Originality: Given the lack of consensus on how performance measurement systems can influence employee experiences and outcomes, this study combines theories that argue for performance measurement systems in managing operations with models developed by psychologists to describe how perceptions of the work conditions can affect employee attitude and wellbeing. A conceptual model is therefore developed and tested, and potential direct and indirect effects of performance measurement systems in the health sector are inferred.

Publication Type: Article
Additional Information: Copyright © 2023, Lilian M. de Menezes and Ana B. Escrig-Tena License Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at
Publisher Keywords: performance measurement systems; job demands; job resources; employeeoutcomes; British health and care sector
Subjects: H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments: Bayes Business School > Management
SWORD Depositor:
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