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The Regional Organization of Hospital Care in Italy: The Effects of Asymmetry of Information and Soft Budget Constraint Rules

In: Italian Institutional Reforms: A Public Choice Perspective

Author

Listed:
  • Rosella Levaggi

    (Università degli Studi di Brescia)

Abstract

In Italy, as in many other western countries, a substantial proportion of health care is financed by the public sector. The health care system has been widely reformed and a separation between purchasing and delivering the service has been enforced to mimic the structure of a competitive market in order to improve efficiency. The organization of the internal market can, however, vary among Regions. The aim of this paper is to assess the relative merits of the different forms of organization for secondary care in a context of information asymmetry. We show that both private and public hospitals can pursue objectives that are not compatible with cost minimization. In this environment the role of the purchaser and the Region is fundamental: unless they enforce hard budget constraint rules, the system might end up being a source of deficit which will ultimately undermine the reform and its long-run sustainability. Key words: Internal markets, asymmetry of information, hospital care, privatization, Italy.

Suggested Citation

  • Rosella Levaggi, 2008. "The Regional Organization of Hospital Care in Italy: The Effects of Asymmetry of Information and Soft Budget Constraint Rules," Springer Books, in: Fabio Padovano & Roberto Ricciuti (ed.), Italian Institutional Reforms: A Public Choice Perspective, chapter 0, pages 197-219, Springer.
    • Handle: RePEc:spr:sprchp:978-0-387-72141-5_11
    DOI: 10.1007/978-0-387-72141-5_11
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    Citations

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    Cited by:

    1. Martini, Gianmaria & Levaggi, Rosella & Spinelli, Daniele, 2022. "Is there a bias in patient choices for hospital care? Evidence from three Italian regional health systems," Health Policy, Elsevier, vol. 126(7), pages 668-679.
    2. Levaggi, Laura & Levaggi, Rosella, 2020. "Is there scope for mixed markets in the provision of hospital care?," Social Science & Medicine, Elsevier, vol. 247(C).
    3. Marcello Montefiori & Michela Pasquarella & Paolo Petralia, 2020. "The effectiveness of the neonatal diagnosis-related group scheme," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-12, August.
    4. Paolo Berta & Carla Guerriero & Rosella Levaggi, 2018. "The dark side of fiscal federalism:evidence from hospital care in Italy," Working papers 72, Società Italiana di Economia Pubblica.

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