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Developing a combined quantitative benchmarking system for the performance of local health authorities: The case of the Tuscany Region in Italy


Author Info

  • Sabina Nuti

    (Laboratorio MeS, Scuola Superiore Sant’Anna, Pisa, Italy)

  • Cinzia Daraio

    (University of Bologna, CIEG Department of Management, Bologna.)

  • Chiara Speroni

    (Laboratorio MeS, Scuola Superiore Sant’Anna, Pisa, Italy)

  • Milena Vainieri

    (Laboratorio MeS, Scuola Superiore Sant’Anna, Pisa, Italy)


This paper proposes an integrated quantitative benchmarking approach for the measurement of the performance of Local Health Authorities (LHAs). It is based on a sound balanced scorecard approach developed and implemented in the Tuscany Region by the Management and Health Laboratory of Sant’Anna School combined with a bias corrected measure of technical efficiency, estimated using a bootstrap based Data Envelopment Analysis. The empirical results show that the typical LHA in Tuscany experienced 14% bias-corrected inefficiency in 2007. Using correlation analysis and mapping quadrants, the paper shows the relationships among technical efficiency and quality and appropriateness as well as analyses the impact of organizational factors on the performance of LHAs. Finally, this combined benchmarking approach is illustrated as a useful and important managerial tool both for regional and local authorities.

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Bibliographic Info

Paper provided by Scuola Superiore Sant'Anna of Pisa, Laboratorio MeS in its series Working Papers with number 200903.

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Date of creation: 01 Mar 2009
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Handle: RePEc:ssf:wpaper:200903

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Keywords: appropriateness; bias correction; data envelopment analysis; local health authorities; performance evaluation system;


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