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The role of Intermediate Entities in the governance of regional health systems: From the analysis of emerging structures to the case of Calabria

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  • Giorgia Rotundo
  • Monica Giancotti
  • Giuseppe Profiti
  • Luca Reali
  • Marianna Mauro

Abstract

Following the institutional and governance structure changes of the 1990s reforms, Italian regional health systems have undergone a re-centralization process which leads to the creation of Intermediate Entities located among the Region and health structures.The study aims to provide an overview of the functions attributed to the Intermediate Entities, focusing on the Calabria Region, the last in the establishment.The analysis of the functions performed provides the first observations about the points of convergence and divergence among the emerging institutional structures.Regarding the Calabrian case, apart from the considerable advantages, the critical issues related to the establishment of the new Entity are not negligible, both relating to the internal regional order and to the future operational phase.

Suggested Citation

  • Giorgia Rotundo & Monica Giancotti & Giuseppe Profiti & Luca Reali & Marianna Mauro, 2024. "The role of Intermediate Entities in the governance of regional health systems: From the analysis of emerging structures to the case of Calabria," MECOSAN, FrancoAngeli Editore, vol. 2024(131), pages 7-31.
    • Handle: RePEc:fan:mesame:v:html10.3280/mesa2024-131oa20236
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    References listed on IDEAS

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    1. Mauro, Marianna & Maresso, Anna & Guglielmo, Annamaria, 2017. "Health decentralization at a dead-end: towards new recovery plans for Italian hospitals," Health Policy, Elsevier, vol. 121(6), pages 582-587.
    2. Ferrè, Francesca & Cuccurullo, Corrado & Lega, Federico, 2012. "The challenge and the future of health care turnaround plans: Evidence from the Italian experience," Health Policy, Elsevier, vol. 106(1), pages 3-9.
    3. Mauro, Marianna & Maresso, Anna & Guglielmo, Annamaria, 2017. "Health decentralization at a dead-end: towards new recovery plans for Italian hospitals," LSE Research Online Documents on Economics 74066, London School of Economics and Political Science, LSE Library.
    4. Baskaran, Thushyanthan, 2011. "Fiscal decentralization, ideology, and the size of the public sector," European Journal of Political Economy, Elsevier, vol. 27(3), pages 485-506, September.
    5. repec:bla:pmomgt:v:26:y:2006:i:1:p:55-62 is not listed on IDEAS
    6. Jose A. Puppim De Oliveira & Yijia Jing & Paul Collins & Paul Smoke, 2015. "Rethinking Decentralization: Assessing Challenges to a Popular Public Sector Reform," Public Administration & Development, Blackwell Publishing, vol. 35(2), pages 97-112, May.
    7. Cavalieri, Marina & Ferrante, Livio, 2016. "Does fiscal decentralization improve health outcomes? Evidence from infant mortality in Italy," Social Science & Medicine, Elsevier, vol. 164(C), pages 74-88.
    8. Kevin Morrell, 2006. "Governance, Ethics and the National Health Service," Public Money & Management, Taylor & Francis Journals, vol. 26(1), pages 55-62, January.
    9. José M. Alonso & Judith Clifton & Daniel Díaz-Fuentes, 2015. "Did New Public Management Matter? An empirical analysis of the outsourcing and decentralization effects on public sector size," Public Management Review, Taylor & Francis Journals, vol. 17(5), pages 643-660, May.
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