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Background. Some Polish hospitals are in a good financial position but others are not, even though they are of a similar size according to their budgets, the number and structure of specialists and type of society they serve. Furthermore, it is difficult to find the factors responsible for their different financial standing. To investigate deeper the dissimilarities that might exist, the author hypothesizes that one of the most important factors that possibly influences a hospitals financial performance is its control system. Research aims. In these circumstances the research is aimed at identifying different control areas and mechanisms which have been used by hospital managers to ensure delivery of high-quality cost-effective patient care and that concurrently balance the hospital budget. Method. During the study the author investigated the operating core of hospitals in order to develop a deeper understanding of its internal control processes. This qualitative study is based on several in-depth interviews with general directors of two similar hospitals. Key findings. The research indicates that hospitals ought to concentrate on four generic areas of control: input control, legitimacy of medical procedures control, revenue control and overheads control. Thus comparing the studied hospitals according to their activities in the four control areas it is visible that the hospital which has a good financial situation, takes control measures in all four areas, and the top managers are directly involved in supervising most of these activities. While the hospital which is facing financial difficulties, is much less active in the described areas of control and the director does not participate actively in control of the lower levels of his organization nor does he build such extended control mechanisms as the director from the better-off hospital. [ABSTRACT FROM AUTHOR]