Esternalizzazione e centralizzazione dei processi di approvvigionamento: risultati e criticitÀ dell'esperienza degli Estav nella sanitÀ toscana

Abstract

Le opportunitÀ ed i vantaggi derivanti dall'esternalizzazione e dalla centralizzazione dei processi aziendali, evidenziati in letteratura nel contesto privato, sono riscontrabili anche nel contesto sanitario pubblico? L'articolo si propone di compiere una prima valutazione dei risultati raggiunti in Toscana con l'introduzione degli ESTAV, la cui istituzione č avvenuta per razionalizzare, a livello sovra-aziendale, le funzioni tecnicoamministrative ed in particolare gli approvvigionamenti. Valutando i risultati raggiunti in termini di efficienza e di efficacia, viene evidenziato come tale esperienza presenti, pur con ampi spazi di miglioramento, risultati indubbiamente positivi e assimilabili a quelli presenti nel contesto privato.

Logistics and procurement outsourcing in the healthcare sector: A comparative analysis

“…Table 3 illustrates the changes in volume, value and cost savings for procurement of the Central ESTAV (Rapporto Oasi, 2011). 9 The data was sourced from the ESTAVs' performance annual reports (2003-09), Rapporto Oasi (2011), Panero et al (2010 and Lega et al (2013). All the data in the public domain was cross-checked in order to assure its reliability and validity.…”

“…11 In 2006 the Central ESTAV managed more than 45% of the RHS expenditure, while the North ESTAV was 27% and South ESTAV 28%. The distribution of employees in 2005 was as follows: Central ESTAV 89, North ESTAV 77 and South ESTAV 75 (Panero et al, 2010).…”

“…Firstly, the performance and degree of maturity of the three ESTAVs is not homogeneous, with non-trivial implications for supplier relationship management. For example, Panero et al (2010) show that in more than 37% of tenders activated in 2007 there was only one supplier involved, while 40% of the tenders involved two to five suppliers. Data suggests that the ESTAVs' ability to involve multiple suppliers to tender was limited and the benefits for increased bargaining power not maximised.…”

“…These sources included: ESTAVs' performance annual reports (2003-09), Lega et al (2013), Panero et al (2010) and Rapporto Oasi (2011). For the qualitative data it was not possible to gain access for interviews; however, the aforementioned publicly available secondary sources provided a rich source of information on the outsourcing, as demonstrated by the case analysis in Section 4.…”

“…The main responsibilities of each ESTAV were the centralisation and rationalisation of procurement and other functions on behalf of the LHAs localised respectively in each of the three AVs. ESTAV recognised that they aim to deliver price reductions and internal operating efficiency improvements derived from EU-compliant procurement and contracting, electronic ordering or online catalogue, and consolidated invoicing and delivery (Panero et al, 2010). The ESTAVs were organised with departments specialised in specific product categories: in-scope product categories, pharmaceuticals, capital equipment, vehicles, hardware/software, and other services.…”