Performance measurement in response to the Tallinn Charter: Experiences from the decentralized Italian framework

Carinci, Fabrizio; Caracci, Gianni; Stanislao, Francesco Di; Moirano, Fulvio

doi:10.1016/j.healthpol.2012.07.010

Cited by 12 publications

(17 citation statements)

References 7 publications

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“…The central government has almost no access to linked data in real time, and there is no formal data flow allowing regions to interconnect their systems and harmonise their preparedness and containment operations. The creation of a modern health information system for decentralised governance has been long discussed as a priority for the National Agency of Regional Health Services 7. However, this arm’s length body was never empowered to reconcile essential levels of health information across the country 8…”

Section: Italy’s Surveillance Systemmentioning

confidence: 99%

Covid-19: preparedness, decentralisation, and the hunt for patient zero

Carinci

2020

BMJ

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Section: Italy’s Surveillance Systemmentioning

confidence: 99%

Covid-19: preparedness, decentralisation, and the hunt for patient zero

Carinci

2020

BMJ

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“…De Vries ( 2000 ) argued that the results of decentralization depend on the cultural and political context, on the administrative capabilities of the actors involved and on how the process is promoted (see also Putnam, 1993 ). The consequence is that there are now 20 regional health care systems (RHSs) in Italy with different governance models and management tools (Formez, 2007 ; Censis, 2008 ; Tediosi et al , 2009 ; Vainieri and Nuti, 2011 ; Carinci et al , 2012 ; Mapelli, 2012 ). France et al ( 2005 ) highlighted the north–south performance disparities in mortality, expenditure and equity up until 2002.…”

Section: The Governance Systems Adopted By Italian Regions In the Heamentioning

confidence: 99%

“…The Aosta Valley has disclosed performance results to internal users rather than to the public. These results are not always translated into policy decisions (Carinci et al , 2012 ).…”

Section: The Governance Systems Adopted By Italian Regions In the Heamentioning

confidence: 99%

Making governance work in the health care sector: evidence from a ‘natural experiment’ in Italy

Nuti

Vola

Bonini

et al. 2015

HEPL

103

136

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The Italian Health care System provides universal coverage for comprehensive health services and is mainly financed through general taxation. Since the early 1990s, a strong decentralization policy has been adopted in Italy and the state has gradually ceded its jurisdiction to regional governments, of which there are twenty. These regions now have political, administrative, fiscal and organizational responsibility for the provision of health care. This paper examines the different governance models that the regions have adopted and investigates the performance evaluation systems (PESs) associated with them, focusing on the experience of a network of ten regional governments that share the same PES. The article draws on the wide range of governance models and PESs in order to design a natural experiment. Through an analysis of 14 indicators measured in 2007 and in 2012 for all the regions, the study examines how different performance evaluation models are associated with different health care performances and whether the network-shared PES has made any difference to the results achieved by the regions involved. The initial results support the idea that systematic benchmarking and public disclosure of data are powerful tools to guarantee the balanced and sustained improvement of the health care systems, but only if they are integrated with the regional governance mechanisms.

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“…We chose these cases because they are considered to be 2 of the best performing Italian regions . Moreover, they both adopted P4P programs together with performance measurement systems, although making different choices in terms of the scheme design . To analyse the above 2 cases, we searched for international and national articles as well as grey literature and Italian documents (Regional acts).…”

Section: Methodsmentioning

confidence: 99%

“…42,43 Moreover, they both adopted P4P programs together with performance measurement systems, although making different choices in terms of the scheme design. 43,44 To analyse the above 2 cases, we searched for international and national articles as well as grey literature and Italian documents (Regional acts). The cases were analysed highlighting the choices that the 2 regions made regarding the financial reward schemes during the time frame under investigation.…”

Section: Methodsmentioning

confidence: 99%

Insights on the effectiveness of reward schemes from 10‐year longitudinal case studies in 2 Italian regions.

Vainieri

Lungu

Nuti

2018

Health Planning & Management

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SummaryBackgroundPay for performance (P4P) programs have been widely analysed in literature, and the results regarding their impact on performance are mixed. Moreover, in the real‐life setting, reward schemes are designed combining multiple elements altogether, yet, it is not clear what happens when they are applied using different combinations.ObjectivesTo provide insights on how P4P programs are influenced by 5 key elements: whom, what, how, how many targets, and how much to reward.MethodsA qualitative longitudinal analysis of 10 years of P4P reward schemes adopted by the regional administrations of Tuscany and Lombardy (Italy) was conducted. The effects of the P4P features on performance are discussed considering both overall and specific indicators.ResultsBoth regions applied financial reward schemes for General Managers by linking the variable pay to performance. While Tuscany maintained a relatively stable financial incentive design and governance tools, Lombardy changed some elements of the design and introduced, in 2012, a P4P program aimed to reward the providers. The main differences between the 2 cases regard the number of targets (how many), the type (what), and the method applied to set targets (how).ConclusionConsidering the overall performance obtained by the 2 regions, it seems that whom, how, and how much to reward are not relevant in the success of P4P programs; instead, the number (how many) and the type (what) of targets set may influence the performance improvement processes driven by financial reward schemes.

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Performance measurement in response to the Tallinn Charter: Experiences from the decentralized Italian framework

Cited by 12 publications

References 7 publications

Covid-19: preparedness, decentralisation, and the hunt for patient zero

Covid-19: preparedness, decentralisation, and the hunt for patient zero

Making governance work in the health care sector: evidence from a ‘natural experiment’ in Italy

Insights on the effectiveness of reward schemes from 10‐year longitudinal case studies in 2 Italian regions.

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