Costing Counting and Comparability: Aspects of Performance Measurement in a Pathology Laboratory Available to Purchase

The motivation for this paper is to better understand the strengths and limitations of quantitative performance measures in a changing environment. The context is one of organisational change and innovative management. Using a case study approach, the paper presents a history of organisational change and focuses on attempts to drive and assess efficiency through performance measures in a public hospital‐based pathology laboratory. The various financial and non‐financial performance measures used in the laboratory are presented. A discrepancy between accounting reports and laboratory management analyses of costs is reported. The notorious difficulties of costing health services are examined through the dispute that arose about whether the mean cost‐per‐test was increasing or decreasing over a three‐year period. Competing representations of performance are analysed. Whilst the case study looks at a New Zealand example, many of the pressures facing pathology services are typical of medical laboratories worldwide. General issues of performance measurement are discussed.