Exploring the mechanisms underlying performance comparisons, Performance Comparison and Organizational Service Provision investigates how such assessments shape hospitals’ service provision and medical professionals’ work. With a focus on U.S. health care, this study outlines how medical quality was defined and compared in the hospital sector from the late 19th century to the present. Developing a novel theoretical framework to investigate performance comparisons, several different forms of internal and external performance assessments are contrasted throughout this period. The transformative effects of these comparisons on hospitals’ relationships to patients, insurers, regulators, and staff are analyzed and their ramifications for current hospital care are explored. Drawing on this analysis, the book examines the controversial nature of these measures and the struggles among hospital managers, patients, physicians, and policy makers to determine hospital quality. Affording a deeper understanding of how performance comparisons influence organizational service provision, the book will be of interest to researchers in a broad range of fields including organization studies, accountability and evaluation, health care, and policy research as well as practitioners in hospital care and management.