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Quasi-market and cost-containment in Beveridge systems: The Lombardy model of Italy

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  • Brenna, Elenka

Abstract

In the very recent past, the Lombardy health care system – established in 1997 on the quasi market model – has caught the interest of researchers and politicians in different OECD countries11See for example the Wall Street Journal, Tuesday, April 13, 2010, R2.. Its merits, compared to other Italian regional systems, are the control of health care spending and the balanced budget, in a frame of good quality of services and patient choice.

Suggested Citation

  • Brenna, Elenka, 2011. "Quasi-market and cost-containment in Beveridge systems: The Lombardy model of Italy," Health Policy, Elsevier, vol. 103(2), pages 209-218.
    • Handle: RePEc:eee:hepoli:v:103:y:2011:i:2:p:209-218
    DOI: 10.1016/j.healthpol.2011.10.003
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    References listed on IDEAS

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    1. George France & Francesco Taroni & Andrea Donatini, 2005. "The Italian health‐care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 187-202, September.
    2. Berta, Paolo & Callea, Giuditta & Martini, Gianmaria & Vittadini, Giorgio, 2010. "The effects of upcoding, cream skimming and readmissions on the Italian hospitals efficiency: A population-based investigation," Economic Modelling, Elsevier, vol. 27(4), pages 812-821, July.
    3. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
    4. Aleksandra Torbica & Giovanni Fattore, 2005. "The “Essential Levels of Care” in Italy: when being explicit serves the devolution of powers," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 46-52, November.
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    6. Carol Propper & Deborah Wilson & Simon Burgess, 2005. "Extending Choice In English Health Care: The implications of the economic evidence," The Centre for Market and Public Organisation 05/133, The Centre for Market and Public Organisation, University of Bristol, UK.
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    Cited by:

    1. Cinzia Di Novi & Dino Rizzi & Michele Zanette, 2016. "Larger is Better: the Scale Effects of the Italian Local Healthcare Authorities Amalgamation Program," Working Papers 2016:04, Department of Economics, University of Venice "Ca' Foscari".
    2. Marta Angelici & Paolo Berta & Joan Costa-Font & Gilberto Turati, 2023. "Divided We Survive? Multilevel Governance during the COVID-19 Pandemic in Italy and Spain," Publius: The Journal of Federalism, CSF Associates Inc., vol. 53(2), pages 227-250.
    3. Alina Peluso & Paolo Berta & Veronica Vinciotti, 2019. "Do pay-for-performance incentives lead to a better health outcome?," Empirical Economics, Springer, vol. 56(6), pages 2167-2184, June.
    4. repec:ctc:serie1:def9 is not listed on IDEAS
    5. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    6. Elenka Brenna, 2018. "Rich and Well Educated: Are These Requirements Necessary to Claim Healthcare Tax Credits in Italy?," Applied Health Economics and Health Policy, Springer, vol. 16(2), pages 207-217, April.
    7. Berta, P.; & De Fraja, G.; & Verzillos, S.;, 2018. "Optimal Healthcare Contracts:Theory and Empirical Evidence from Italy," Health, Econometrics and Data Group (HEDG) Working Papers 18/33, HEDG, c/o Department of Economics, University of York.
    8. Francese, Maura & Piacenza, Massimiliano & Romanelli, Marzia & Turati, Gilberto, 2014. "Understanding inappropriateness in health spending: The role of regional policies and institutions in caesarean deliveries," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 262-277.
    9. Moscone, Francesco & Siciliani, Luigi & Tosetti, Elisa & Vittadini, Giorgio, 2020. "Do public and private hospitals differ in quality? Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 83(C).
    10. Brenna, Elenka & Polistena, Barbara & Spandonaro, Federico, 2023. "Analysing outpatient care access for planning purposes: The Basilicata Region experience," Evaluation and Program Planning, Elsevier, vol. 99(C).
    11. Berta, Paolo & Guerriero, Carla & Levaggi, Rosella, 2021. "Hospitals’ strategic behaviours and patient mobility: Evidence from Italy," Socio-Economic Planning Sciences, Elsevier, vol. 77(C).
    12. Cavalieri, M. & Guccio, C. & Lisi, D. & Pignataro, G., 2015. "Does the Extent of Per-Case Payment System Affect Hospital Efficiency? Evidence from the Italian NHS," Health, Econometrics and Data Group (HEDG) Working Papers 15/29, HEDG, c/o Department of Economics, University of York.
    13. Brenna, Elenka, 2025. "Public versus private access in the Italian NHS - The use of propensity score matching to provide more insight on the increasing adoption of voluntary health insurance," Health Policy, Elsevier, vol. 154(C).
    14. Giovanni Guarducci & Gabriele Messina & Simona Carbone & Andrea Urbani & Nicola Nante, 2022. "Inter-Regional Patients’ Migration for Hospital Orthopedic Intensive Rehabilitation: The Italian Experience," IJERPH, MDPI, vol. 19(21), pages 1-11, October.
    15. 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.
    16. Cappellari, Lorenzo & De Paoli, Anna & Turati, Gilberto, 2014. "Do Market Incentives in the Hospital Industry Affect Subjective Health Perceptions? Evidence from the Italian PPS-DRG Reform," IZA Discussion Papers 8636, IZA Network @ LISER.
    17. Berta, P.; & Martini, G.; & Piacenza, M.; & Turati, G.;, 2019. "The strange case of appropriate C-sections:DRG-tariff regulation, hospital ownership, and market concentration," Health, Econometrics and Data Group (HEDG) Working Papers 19/02, HEDG, c/o Department of Economics, University of York.
    18. Ghislandi, Simone & Renner, Anna-Theresa & Varghese, Nirosha Elsem, 2025. "The impact of budget cuts on individual patient health: Causal evidence from hospital closures," Journal of Health Economics, Elsevier, vol. 101(C).
    19. Elenka Brenna & Federico Spandonaro, 2014. "Does federalism induce patients’ mobility across regions? Evidence from the Italian experience," DISCE - Working Papers del Dipartimento di Economia e Finanza def009, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    20. Berta, Paolo & Lovaglio, Pietro Giorgio & Verzillo, Stefano, 2021. "How have casemix, cost and hospital stay of inpatients in the last year of life changed over the past decade? Evidence from Italy," Health Policy, Elsevier, vol. 125(8), pages 1031-1039.
    21. 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.
    22. Maria Lucia Specchia & Andrea Di Pilla & Martina Sapienza & Maria Teresa Riccardi & Americo Cicchetti & Gianfranco Damiani & Instant Report Group, 2021. "Dealing with COVID-19 Epidemic in Italy: Responses from Regional Organizational Models during the First Phase of the Epidemic," IJERPH, MDPI, vol. 18(9), pages 1-14, May.
    23. Paolo Berta & Gianmaria Martini & Massimiliano Piacenza & Gilberto Turati, 2020. "The strange case of less C‐sections: Hospital ownership, market concentration, and DRG‐tariff regulation," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 30-46, October.
    24. Cinzia Di Novi & Dino Rizzi & Michele Zanette, 2018. "Scale Effects and Expected Savings from Consolidation Policies of Italian Local Healthcare Authorities," Applied Health Economics and Health Policy, Springer, vol. 16(1), pages 107-122, February.
    25. 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.

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    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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