Suchergebnisse

The article examines the implementation by the Italian Ministry of Health of performance-based funding to allocate resources for research to IRCCS (Istituti di Ricovero e Cura a Carattere Scientifico) hospitals. The analysis provides evidence that ten years from its introduction the performance-based funding system has persisted, but it has been implemented rather differently from what had been imagined by its proponents. By drawing on the theoretical frameworks of policy implementation, agency, and relational contracting, the study establishes that the overall design of the system has contributed to this final outcome only to a limited extent. Rather, the lack of procedural fairness, as well as of political leadership in linking the system to national research priorities, has undermined the basis for trust between hospitals and the Ministry of Health. The article discusses how, in this, the governance of performance-based funding and its strong ownership by the ministerial bureaucracy has been determinant. Adapted from the source document.

This volume elaborates on the intrinsic perspectives on ambiguity as an inherent part of organizational decision-making processes and the more recent strategic perspectives on discursively constructed strategic ambiguity. It helps illuminate the path ahead of organizational scholars and offers new avenues for future research.

Multiprofessional primary care models promise to deliver better care and reduce waste. This study evaluates the impact of such a model, the primary care unit (PCU), on three outcomes. A multilevel analysis within a "pre- and post-PCU" study design and a cross-sectional analysis were conducted on 215 PCUs located in the Emilia-Romagna region in Italy. Seven dimensions captured a set of processes and services characterizing a well-functioning PCU, or its degree of vitality. The impact of each dimension on outcomes was evaluated. The analyses show that certain dimensions of PCU vitality (i.e., the possibility for general practitioners to meet and share patients) can lead to better outcomes. However, dimensions related to the interaction and the joint works of general practitioners with other professionals tend not to have a significant or positive impact. This suggests that more effort needs to be invested to realize all the potential benefits of the PCU's multiprofessional approach to care.

AbstractHybrid professionals, that is, professionals who have transitioned to managerial roles, have emerged in numerous public settings. Through in‐depth qualitative methodologies, the literature has shown a good degree of heterogeneity in the way hybrid professionals perceive and manage their hybridity. In this study, we aim to develop a theory‐based, multidimensional instrument able to capture such heterogeneity in a lean but sensitive way. In this instrument, we combine consolidated scales of identity centrality and integration and vignettes, on the one hand, to measure the perception of hybrid professionals of the relationship between their professional and managerial identities and, on the other hand, to elicit the practices they use to deal with the demands of the professional and managerial logics. We first validate the instrument on a sample of school principals in the Italian context and then describe the six profiles of hybrid professionals derived from the analysis. We suggest three avenues for applying such an instrument.

On 31st January 2020, the Italian cabinet declared a 6-month national emergency after the detection of the first two COVID-19 positive cases in Rome, two Chinese tourists travelling from Wuhan. Between then and the total lockdown introduced on 22nd March 2020 Italy was hit by an unprecedented crisis. In addition to being the first European country to be heavily swept by the COVID-19 pandemic, Italy was the first to introduce stringent lockdown measures. The SARS-CoV-2 outbreak and related COVID-19 pandemic have been the worst public health challenge endured in recent history by Italy. Two months since the beginning of the first wave, the estimated excess deaths in Lombardy, the hardest hit region in the country, reached a peak of more than 23,000 deaths. The extraordinary pressures exerted on the Italian Servizio Sanitario Nazionale (SSN) inevitably leads to questions about its preparedness and the appropriateness and effectiveness of responses implemented at both national and regional levels. The aim of the paper is to critically review the Italian response to the COVID-19 crisis spanning from the first early acute phases of the emergency (March-May 2020) to the relative stability of the epidemiological situation just before the second outbreak in October 2020.

In this paper, we aim to critically review the Italian response to the COVID-19 crisis spanning from the early acute phases of the emergency (March-May 2020) to the relative stability of the epidemiological situation just before the second outbreak in October 2020. In what follows, we first briefly describe how the Italian Servizio Sanitario Nazionale (SSN, National Health Services) is organised and the preparedness of the SSN before the epidemic started. Second, we describe the governance of the emergency set up by the government. Finally, we attempt a first assessment of the effects that the COVID-19 crisis had on the Italian healthcare system, separately addressing supply-side and demand-side considerations.

The paper discusses the responses to the COVID-19 crisis in the acute phase of the first wave of the pandemic (February-May 2020) by different Italian regions in Italy, which has a decentralised healthcare system. We consider five regions (Lombardy, Veneto, Emilia-Romagna, Umbria, Apulia) which are located in the north, centre and south of Italy. These five regions differ both in their healthcare systems and in the extent to which they were hit by the first wave of COVID-19 pandemic. We investigate their different responses to COVID-19 reflecting on seven management factors: (1) monitoring, (2) learning, (3) decision-making, (4) coordinating, (5) communicating, (6) leading, and (7) recovering capacity. In light of these factors, we discuss the analogies and differences among the regions and their different institutional choices.