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The present research aims to understand the performance disclosure levels provided by Italian healthcare organisations (HCOs). The authors conducted this study to assess the transparency of HCOs' performance reporting processes by examining the amount and the type of information disclosed in Annual Performance Reports (APRs).

The present study uses a qualitative research methodology based on manual content analysis. The APRs of a sample of 171 Italian public HCOs were analysed.

Results evidence that the APRs provide a sufficient level of disclosure of performance information, putting high attention on the epidemiological conditions; however, the APRs do not present a strong information function for stakeholders' decision-making purposes. The Italian HCOs APRs are not easily understandable because the APRs are not very concise and present information mainly in discursive terms with limited graphic support.

To the best of the authors' knowledge, this is the first research investigating both the extent and type of performance information reported by Italian HCOs in the APRs, considering the particular contextual conditions caused by the most significant challenge the healthcare (HC) sector has faced in recent years: the epidemiological crisis of the coronavirus disease 2019 (COVID-19). The study also explores whether APRs are currently used by HCOs as a merely regulatory requirement or as an information tool for accountability and decision-making purposes.