Is the Appointee Procedure a Real Selection or a Mere Political Exchange? The Case of the Italian Health-Care Chief Executive Officers

One of the central aspects of the Italian health-care reform deals with the new position of a chief executive officer (CEO) selected through an appointment procedure. By drawing data from 164 Curriculum Vitae (CVs), a cluster analysis was carried out to investigate the typologies of CEOs that were selected and assess them by comparing their educational and professional characteristics. Three different categories of CEOs are defined and ranked: (i) “experienced CEO”, with the highest inter-organizational mobility and the highest number of triad-assignments; (ii) “experienced local directors”, with a better cultural background, medium mobility and medium number of triad assignments; and (iii) “business like professionals” with the lowest professional and educational profile. How these typologies are distributed over the Italian regions gathered in groups were then verified, considering the kind of organizational arrangements in the local appointment procedures. Finally, the overall results of the CEOs selection system in health-care lead to suboptimal appointments: when the organizational arrangements are better employed, they totally exclude the selection of the lowest category. On the contrary, when organizational arrangements are wrongly employed the first category decreases where the second increases.