COVID-19 uncertainty, pandemic management strategy, management control and public health performance

Purpose - Although the use of management control systems (MCS) in crisis management has received extensive attention, limited knowledge exists regarding the benefits of the broad scope, timeliness, integration and aggregation dimensions. This study aims at examining the performance implications of the context-structure combinations of pandemic management strategy (PMS), MCS use and pandemic-induced uncertainty of public health institutions (PHIs) in Ghana. Design/methodology/approach - Data were collected using online survey questionnaire where 246 public health managers qualified for the study. Data were analyzed using covariance-based structural equations modeling (version 23). Findings - PMS was found to have a significant and positive impact on three (broad scope, timeliness and aggregation) of the four dimensions. The integrated dimension was statistically insignificant. In addition, the three dimensions had a significant impact on top managers' satisfaction with MCS use, which in turn impact on cost containment and quality of care. Finally, COVID-19 uncertainty moderated the relationship between MCS use and operational performance. Practical implications - The three dimensions of broad scope, timeliness and aggregation are critical for PHIs when it comes to crisis management. Moreover, the presence of pandemics strengthens the relationship between top manager use of MCS and performance in health care. More sophisticated MCS information is required when managing pandemic-related crisis by PHIs. Originality/value - This study presents a theoretical framework that integrates PMS, MCS use and performance of public health care from a contingency perspective. It extends the benefits of contingency theory to include the three dimensions of MCS with respect to crisis management.