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This article attempts to devise an integrated performance measurement framework to assess the Hong Kong Hospital Authority (HA) management system by harnessing previous performance measurement systems.

An integrated evaluative framework based on the balanced score card (BSC) was developed and applied using the case study method and longitudinal data to evaluate the HA's performance management system.

The authors unveil evolving HA performance indicators (PI). Despite the HA staff's explicit quality emphasis, cost control remains the primary focus in their performance measurements.

Data used in this study are from secondary sources, disclosed mostly by HA staff.

This study shows public sector staff often attach too much importance to cost control and easily measurable activities …