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Disinvestment for re-allocation: A process to identify priorities in healthcare

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  • Nuti, Sabina
  • Vainieri, Milena
  • Bonini, Anna

Abstract

Resource scarcity and increasing service demand lead health systems to cope with choices within constrained budgets. The aim of the paper is to describe the study carried out in the Tuscan Health System in Italy on how to set priorities in the disinvestment process for re-allocation. The analysis was based on 2007 data benchmarking of the Tuscan Health System with an impact on the level of resources used. For each indicator, the first step was to estimate the gap between the performance of each Health Authority (HA) and the best performance or the regional average. The second step was to measure this gap in terms of financial value. The results of the analysis demonstrated that, at the regional level, 2-7% of the healthcare budget can be re-allocated if all the institutions achieve the regional average or the best practice. The implications of this study can be useful for policy makers and the HA top management. In the context of resource scarcity, it allows managers to identify the areas where the institutions can achieve a higher level of efficiency without negative effects on quality of care and instead re-allocate resources toward services with more value for patients.

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  • Nuti, Sabina & Vainieri, Milena & Bonini, Anna, 2010. "Disinvestment for re-allocation: A process to identify priorities in healthcare," Health Policy, Elsevier, vol. 95(2-3), pages 137-143, May.
    • Handle: RePEc:eee:hepoli:v:95:y:2010:i:2-3:p:137-143
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    4. Carinci, Fabrizio & Caracci, Gianni & Di Stanislao, Francesco & Moirano, Fulvio, 2012. "Performance measurement in response to the Tallinn Charter: Experiences from the decentralized Italian framework," Health Policy, Elsevier, vol. 108(1), pages 60-66.
    5. Rooshenas, Leila & Owen-Smith, Amanda & Hollingworth, William & Badrinath, Padmanabhan & Beynon, Claire & Donovan, Jenny L., 2015. "“I won't call it rationing…”: An ethnographic study of healthcare disinvestment in theory and practice," Social Science & Medicine, Elsevier, vol. 128(C), pages 273-281.
    6. Hao Li & Sara Barsanti & Anna Bonini, 2012. "Building China’s Regional Municipal Healthcare Performance Evaluation System: A Tuscan Perspective," Working Papers 201204, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    7. Milena Vainieri & Massimiliano Gallo & Giuseppe Montagano & Sabina Nuti, 2016. "Per migliorare la performance quanto conta l?integrazione tra gli strumenti di governance regionali e aziendali? Alcune evidenze dalla Regione Basilicata," MECOSAN, FrancoAngeli Editore, vol. 2016(98), pages 41-59.
    8. García-Armesto, Sandra & Campillo-Artero, Carlos & Bernal-Delgado, Enrique, 2013. "Disinvestment in the age of cost-cutting sound and fury. Tools for the Spanish National Health System," Health Policy, Elsevier, vol. 110(2), pages 180-185.
    9. Sara Barsanti & Silvia Giovanelli & Sabina Nuti, 2014. "Come valutare la ricerca nelle Aziende Ospedaliero-Universitarie? Metodi e proposte operative," MECOSAN, FrancoAngeli Editore, vol. 2014(90), pages 9-32.
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    11. 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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