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Phasing Out Market Mechanisms in the Italian National Health Service

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  • Eugenio Anessi-Pessina
  • Elena Cantù
  • Claudio Joninii

Abstract

The Italian National Health Service introduced quad-markets, regionalization, and managerialism in the 1990s. Under quasi-markets, large providers have been separated from purchasers and funded by ‘activity’—the quantity, mix, and possibly appropriateness of services provided. Under regionalization, each of Italy's 21 regional governments is able to design its own funding arrangements. The regions have generally been trying to mitigate the effects of quasi-markets and are now increasingly ‘governing’ them. The system is producing some desirable results, including a shift from ordinary to same-day hospitalizations and a reduction in length of stay. Hospital admissions increased initially, but only where the regions encouraged this. Financial effects are more controversial.

Suggested Citation

  • Eugenio Anessi-Pessina & Elena Cantù & Claudio Joninii, 2004. "Phasing Out Market Mechanisms in the Italian National Health Service," Public Money & Management, Taylor & Francis Journals, vol. 24(5), pages 309-316, October.
    • Handle: RePEc:taf:pubmmg:v:24:y:2004:i:5:p:309-316
    DOI: 10.1111/j.1467-9302.2004.00439.x
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    References listed on IDEAS

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    1. Piero Giarda, 2000. "Il federalismo fiscale in attuazione della legge n. 133/1999: aspetti tecnici, ragioni e problemi aperti," ECONOMIA PUBBLICA, FrancoAngeli Editore, vol. 2000(5).
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    Cited by:

    1. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    2. De Nicola, Arianna & Gitto, Simone & Mancuso, Paolo, 2011. "A two-stage DEA model to evaluate the efficiency of the Italian health system," MPRA Paper 39126, University Library of Munich, Germany.
    3. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    4. Sofia, AmaralGarcia & Veronica, Grembi, 2011. "Curb your premium! evaluating state intervention in medical malpractice insurance," MPRA Paper 32301, University Library of Munich, Germany.
    5. Barili, E. & Bertoli, P. & Grembi, V. & Rattini, V., 2021. "COVID Angels Fighting Daily Demons? Mental Health of Healthcare Workers and Religion," Health, Econometrics and Data Group (HEDG) Working Papers 21/05, HEDG, c/o Department of Economics, University of York.
    6. Amaral-Garcia, Sofia & Grembi, Veronica, 2014. "Curb your premium: The impact of monitoring malpractice claims," Health Policy, Elsevier, vol. 114(2), pages 139-146.
    7. Finocchiaro Castro, Massimo & Guccio, Calogero & Pignataro, Giacomo & Rizzo, Ilde, 2014. "The effects of reimbursement mechanisms on medical technology diffusion in the hospital sector in the Italian NHS," Health Policy, Elsevier, vol. 115(2), pages 215-229.
    8. 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.
    9. Bertoli, Paola & Grembi, Veronica, 2017. "The political economy of diagnosis-related groups," Social Science & Medicine, Elsevier, vol. 190(C), pages 38-47.
    10. Giovanni Fattore & Aleksandra Torbica, 2006. "Inpatient reimbursement system in Italy: How do tariffs relate to costs?," Health Care Management Science, Springer, vol. 9(3), pages 251-258, August.
    11. Barili, Emilia & Bertoli, Paola & Grembi, Veronica & Rattini, Veronica, 2024. "COVID angels fighting daily demons? Mental well-being of healthcare workers and religiosity," European Economic Review, Elsevier, vol. 162(C).
    12. 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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