Aim: The aim is to create an understanding of how public health organizations have adapted the Balanced Scorecard with regard to customer and economics perspective.

Method: The study was conducted based on a qualitative research method. The study was inspired by a hermeneutic approach. Data were collected from 12 interviews which then were analyzed with help of previous research.

Result & Conclusions: The Balanced Scorecard is limited in its design because of the politicians. The economic perspective is as important as the other perspectives but the perspective is limited because the health care can not affect the budget. The customer perspective focuses on national guidelines where waiting times have been a major focus.

Suggestions for future research: The study only includes studies within one county council and we therefore believe that future studies could explore how other hospitals in other county councils have adapted their scorecards.