IDEAS home Printed from https://ideas.repec.org/a/cup/hecopl/v11y2016i01p17-38_00.html
   My bibliography  Save this article

Making governance work in the health care sector: evidence from a ‘natural experiment’ in Italy

Author

Listed:
  • Nuti, Sabina
  • Vola, Federico
  • Bonini, Anna
  • Vainieri, Milena

Abstract

The Italian Health care System provides universal coverage for comprehensive health services and is mainly financed through general taxation. Since the early 1990s, a strong decentralization policy has been adopted in Italy and the state has gradually ceded its jurisdiction to regional governments, of which there are twenty. These regions now have political, administrative, fiscal and organizational responsibility for the provision of health care. This paper examines the different governance models that the regions have adopted and investigates the performance evaluation systems (PESs) associated with them, focusing on the experience of a network of ten regional governments that share the same PES. The article draws on the wide range of governance models and PESs in order to design a natural experiment. Through an analysis of 14 indicators measured in 2007 and in 2012 for all the regions, the study examines how different performance evaluation models are associated with different health care performances and whether the network-shared PES has made any difference to the results achieved by the regions involved. The initial results support the idea that systematic benchmarking and public disclosure of data are powerful tools to guarantee the balanced and sustained improvement of the health care systems, but only if they are integrated with the regional governance mechanisms.

Suggested Citation

  • Nuti, Sabina & Vola, Federico & Bonini, Anna & Vainieri, Milena, 2016. "Making governance work in the health care sector: evidence from a ‘natural experiment’ in Italy," Health Economics, Policy and Law, Cambridge University Press, vol. 11(1), pages 17-38, January.
  • Handle: RePEc:cup:hecopl:v:11:y:2016:i:01:p:17-38_00
    as

    Download full text from publisher

    File URL: https://www.cambridge.org/core/product/identifier/S1744133115000067/type/journal_article
    File Function: link to article abstract page
    Download Restriction: no
    ---><---

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Daniel Adrian Lungu & Elisa Foresi & Paolo Belardi & Sabina Nuti & Andrea Giannini & Tommaso Simoncini, 2021. "The Impact of New Surgical Techniques on Geographical Unwarranted Variation: The Case of Benign Hysterectomy," IJERPH, MDPI, vol. 18(13), pages 1-14, June.
    2. Martini, Gianmaria & Levaggi, Rosella & Spinelli, Daniele, 2022. "Is there a bias in patient choices for hospital care? Evidence from three Italian regional health systems," Health Policy, Elsevier, vol. 126(7), pages 668-679.
    3. Lenzi, Jacopo & Noto, Guido & Corazza, Ilaria & Lepiksone, Jana & Fantini, Maria Pia, 2020. "Measuring the quality of care in small countries: the empirical analysis of 30-day mortality following acute myocardial infarction and ischaemic stroke in Latvia," Health Policy, Elsevier, vol. 124(7), pages 695-700.
    4. Rossella Verzulli & Gianluca Fiorentini & Matteo Lippi Bruni & Cristina Ugolini, 2017. "Price Changes in Regulated Healthcare Markets: Do Public Hospitals Respond and How?," Health Economics, John Wiley & Sons, Ltd., vol. 26(11), pages 1429-1446, November.
    5. Francesca Casalini & Chiara Seghieri & Michele Emdin & Sabina Nuti, 2017. "Nuovi strumenti di management per la gestione integrata dei percorsi assistenziali dei pazienti cronici," MECOSAN, FrancoAngeli Editore, vol. 2017(102), pages 35-59.
    6. Nicola Giannelli & Andrea Lippi, 2022. "The relevance of non-institutional practice in health care steering at local level in Italy.What has been learnt in pandemic times?," Working Papers 2203, University of Urbino Carlo Bo, Department of Economics, Society & Politics - Scientific Committee - L. Stefanini & G. Travaglini, revised 2022.
    7. De Pourcq, Kaat & De Regge, Melissa & Van den Heede, Koen & Van de Voorde, Carine & Paul, Gemmel & Eeckloo, Kristof, 2019. "The role of governance in different types of interhospital collaborations: A systematic review," Health Policy, Elsevier, vol. 123(5), pages 472-479.
    8. Manila Bonciani & Ilaria Corazza & Sabina Rosis, 2022. "The COVID-19 emergency as an opportunity to co-produce an innovative approach to health services provision: the women's antenatal classes move on the web," Italian Journal of Marketing, Springer, vol. 2022(1), pages 59-85, March.
    9. Paolo Belardi & Ilaria Corazza & Manila Bonciani & Fabio Manenti & Milena Vainieri, 2022. "Evaluating Healthcare Performance in Low- and Middle-Income Countries: A Pilot Study on Selected Settings in Ethiopia, Tanzania, and Uganda," IJERPH, MDPI, vol. 20(1), pages 1-18, December.
    10. Francesca Ferrè & Bruna Vinci & Anna Maria Murante, 2019. "Performance of care for end‐of‐life cancer patients in Tuscany: The interplay between place of care, aggressive treatments, opioids, and place of death. A retrospective cohort study," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1251-1264, October.
    11. De Rosis, Sabina & Guidotti, Elisa & Zuccarino, Sara & Venturi, Giulia & Ferré, Francesca, 2020. "Waiting time information in the Italian NHS: A citizen perspective," Health Policy, Elsevier, vol. 124(8), pages 796-804.
    12. Berta, P. & Bratti, M. & Fiorio, C.V. & Pisoni, E. & Verzillo, S., 2021. "Administrative border effects in Covid-19 related mortality," Health, Econometrics and Data Group (HEDG) Working Papers 21/21, HEDG, c/o Department of Economics, University of York.
    13. Horenberg, Frank & Lungu, Daniel Adrian & Nuti, Sabina, 2020. "Measuring research in the big data era: The evolution of performance measurement systems in the Italian teaching hospitals," Health Policy, Elsevier, vol. 124(12), pages 1387-1394.
    14. Yuxi Wang & Simone Ghislandi & Aleksandra Torbica, 2020. "Investigating the geographic disparity in quality of care: the case of hospital readmission after acute myocardial infarction in Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1149-1168, November.
    15. Guido Noto & Ilaria Corazza & Kristīne Kļaviņa & Jana Lepiksone & Sabina Nuti, 2019. "Health system performance assessment in small countries: The case study of Latvia," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1408-1422, October.
    16. Seghieri, Chiara & Berta, Paolo & Nuti, Sabina, 2019. "Geographic variation in inpatient costs for Acute Myocardial Infarction care: Insights from Italy," Health Policy, Elsevier, vol. 123(5), pages 449-456.
    17. Sabina Nuti & Guido Noto & Tommaso Grillo Ruggieri & Milena Vainieri, 2021. "The Challenges of Hospitals’ Planning & Control Systems: The Path toward Public Value Management," IJERPH, MDPI, vol. 18(5), pages 1-14, March.
    18. Andrea Riganti, 2021. "Containing costs in the Italian local healthcare market," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1001-1014, May.
    19. Nuti, Sabina & Ferré, Francesca & Seghieri, Chiara & Foresi, Elisa & Stukel, Therese A., 2020. "Managing the performance of general practitioners and specialists referral networks: A system for evaluating the heart failure pathway," Health Policy, Elsevier, vol. 124(1), pages 44-51.
    20. Rosanna Spanò & Adele Caldarelli & Luca Ferri & Marco Maffei, 2020. "Context, culture and control: a case study on accounting change in an Italian regional health service," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 24(1), pages 229-272, March.
    21. Noto, Guido & Belardi, Paolo & Vainieri, Milena, 2020. "Unintended consequences of expenditure targets on resource allocation in health systems," Health Policy, Elsevier, vol. 124(4), pages 462-469.
    22. Fabio De Matteis, 2022. "Elementi di performance governance nei servizi sanitari: alcune evidenze empiriche sullo stato dell?arte nella sanità p," MECOSAN, FrancoAngeli Editore, vol. 2022(121), pages 7-30.
    23. Paolo Berta & Carla Guerriero & Rosella Levaggi, 2018. "The dark side of fiscal federalism:evidence from hospital care in Italy," Working papers 72, Società Italiana di Economia Pubblica.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:cup:hecopl:v:11:y:2016:i:01:p:17-38_00. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Kirk Stebbing (email available below). General contact details of provider: https://www.cambridge.org/hep .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.