Performance evaluation is an issue that shaped in the eyes of the beholder. Traditionally financial performance measurement is forefront in performance measurement but modern performance measurement approaches give equal importance to perceptional assessments. The relationship between quality, image and reputation perceptions continue to questioning in the literature which. In this study which is based on hospitals, confirmatory factor analysis was performed for understanding the relationship between the quality, image-reputation, cost and financial performance indicators according to managers assessments. Findings show that quality (beta=0.88, p<0.05) and financial (beta=0.88, p<0.05) performance are prominent indicators of hospital performance. Moreover, it is seen that image and reputation and cost performance are not determinator factors of general performance. These results highlight that effective quality management policy and financial stability are the main drivers of hospital performance.