Abstract
The Balanced Scorecard (BSC) has increasingly been adopted as a strategic performance management framework within healthcare organizations. Evidence from the past decade shows varied implementation outcomes, shaped by institutional readiness, leadership commitment, and the maturity of health information systems. This narrative review synthesizes findings from 47 scientific articles selected through a systematic screening process, covering studies conducted in hospitals, primary health centers, and pharmacy units in Indonesia, Morocco, Iran, China, and other countries. The studies employed case study and descriptive cross-sectional designs using both quantitative and qualitative approaches. Overall, BSC implementation contributed to improvements in service performance across the financial, customer, internal process, and learning and growth perspectives. Key enabling factors included integration of BSC into organizational strategic planning processes, sustained leadership support, regular capacity building for staff, and the reinforcement of a patient-centered culture. Nonetheless, several constraints were identified, including the absence of standardized healthcare KPIs, resistance to change, limited resource allocation, and gaps in data quality and reporting mechanisms. Recent developments demonstrated the use of complementary analytical tools such as SWOT, the Analytic Hierarchy Process, and Health Technology Assessment to strengthen strategic decision-making. These findings indicate that BSC serves as an effective and adaptive performance management framework capable of supporting holistic service improvement in healthcare settings. To maximize its impact, contextual adaptation, enhanced human resource capacity, and stronger health information systems are essential. Further research is needed to examine determinants of successful BSC implementation and to assess its long-term implications for healthcare service performance and policy development.
Recommended Citation
Tunggadewi, Larasati; Alfian, Sofa Dewi; and Suwantika, Auliya A
(2026)
"Balanced Scorecard in Healthcare Facilities: A Ten-Year Review of Strategies to Improve Organizational Effectiveness,"
Pharmacology and Clinical Pharmacy Research: Vol. 11:
Iss.
1, Article 7.
Available at:
https://journal.unpad.ac.id/pcpr/vol11/iss1/7
Page
56
Included in
Medical Pharmacology Commons, Other Pharmacology, Toxicology and Environmental Health Commons, Pharmacoeconomics and Pharmaceutical Economics Commons, Pharmacy Administration, Policy and Regulation Commons
