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Il governo dell’innovazione farmaceutica in Italia. Dallo stato dell’arte a un modello di gestione regionale equa e sostenibile dei farmaci innovativi e ad alto costo
No full textEvaluating the network healthcare system performance. 2014 Results of the Italian Regional Collaborative
No full textIl sistema di valutazione della performance dei sistemi sanitari regionali: Basilicata, Calabria, Emilia-Romagna, Friuli Venezia Giulia, Lazio, Liguria, Marche, P.A. Bolzano, P.A. Trento, Puglia, Sardegna, Toscana, Umbria, Veneto - Report 2014
Full text linkHow to set challenging goals and conduct fair evaluation in regional public health systems. Insights from Valencia and Tuscany Regions
No full textThe definition of “the right targets” and the way the evaluation of results is performed affect the willingness to commit to new challenges, which is a factor that influences the relationship between goal setting and performance results. Indeed, some authors claim that the choice of an inappropriate goal-setting procedure is a major cause of failure of management control systems. Goal setting theorists found that assigning a specific and challenging goal leads to higher performance than (a) an easy goal, (b) a general goal or (c) no goal setting. Despite this evidence, yet, few proposals concern the definition of what is “challenging”. This paper focuses on two issues: (a) what is to be considered a challenging goal and (b) what is a “fair evaluation” in the health care sector. This work suggests that benchmarking is a valid support to solve the previous dilemmas. Relying on two Regional European advanced experiences – Valencia in Spain and Tuscany in Italy –, this paper aims to provide conceptual methods that can help managers define challenging goals and conduct fair evaluation about their achievement. Although these Regions adopted different governance models, both of them applied very similar techniques, which seem to be associated to an improvement of their performance and a reduction of unwarranted variation
Making governance work in the healthcare sector: evidence from a “natural experiment” in Italy
Get PDFThe Italian Health Care System is a public health system which provides universal coverage for comprehensive and essential health services through general taxation. Since the early 1990s, a strong decentralization policy has taken place in Italy and the State has gradually ceded its jurisdiction to the 20 Italian Regions. These Regions now have the political, administrative, and financial responsibility for the provision of health care to their residents. This shift of power has created some interregional differences in the quality of healthcare services.
However, eight Italian Regions have adopted the same Performance Evaluation System (PES) since 2008. It was designed and implemented to monitor about 160 indicators. The Regional Network has offered valuable information and the opportunity to adopt managerial tools that can be used to drive performance improvement and achieve equity.
This paper firstly describes the methodology followed by the eight Regions in defining their priorities and setting their targets, relying on the multidimensional data the Inter-Regional Performance Evaluation System provides.
It secondly enquires how some Regions have applied and adapted this methodology to their characteristics and strategies
Innovatori, indecisi, bisognosi o autonomi. I medici di medicina generale tra integrazione e accountability
No full textL’assistenza primaria in Italia sta subendo una radicale riforma con l’introduzione delle Aggregazioni Funzionali Territoriali (AFT), ovvero gruppi obbligatori di medici di medicina generale che si associano per rispondere insieme sia ai bisogni della popolazione assistita, sia per implementare le logiche del governo clinico. La Toscana già a partire del 2014 è stata una delle prime Regioni a formalizzare le AFT negli Accordi Regionali e Aziendali e a nominare i coordinatori di AFT, ovvero medici di medicina generale che hanno il compito di guidare l’AFT nella programmazione e revisione di obiettivi di governo. A partire da un questionario rivolto ai coordinatori di AFT toscani, gli autori hanno analizzato la percezione dei coordinatori rispetto all’innovazione rappresentata dalla AFT, sia in termini di fiducia verso la logica di integrazione monoprofessionale (fiducia verso l’organizzazione), sia in termini di difficoltà percepita rispetto all’assolvimento del proprio incarico (fiducia verso il ruolo). Sulla base di tali criteri, gli autori hanno delineato, per il contesto della Toscana, 4 differenti gruppi di coordinatori con percezioni simili verso l’innovazione manageriale e organizzativa della medicina generale
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