This article analyzes the interplay of the use of management control systems, organizational learning, management decisions and the performance of health organizations. In the quantitative step, we collected data on 48 Brazilian hospitals and other health facilities by means of a survey. Principal component analysis identified three dimensions of management decisions (financial, costs and client relationship) and two performance dimensions (economic and non-monetary). Structural equation modeling confirmed the following hypotheses: (i) interactive use of the management control system is positively associated with organizational learning (OL); (ii) OL is positively associated with financial decisions and cost and process decisions; (iii) cost and process decisions and decisions related to clients are positively associated with economic performance; and (iv) cost and process decisions are also positively associated with non-monetary performance. In the qualitative step, we interviewed four key informants to discuss and interpret the results.
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