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Marianna Mauro, Giovanna TalaricoDepartment of Clinical and Experimental Medicine, Magna Græcia University of Catanzaro, Catanzaro, ItalyAbstract: The current paper addresses the complex issue of accountability by focusing on Italian public hospitals and teaching hospitals; it aims to analyze Italian health care organizations' strategies for responding to the pressure generated by regulations. In particular, in the last few years, Italian hospitals and teaching hospitals have been obliged to implement or improve their accountability instruments in response to a new regulation (known as the Brunetta reform, Legislative Decree number 150/2009). The Legislative Decree aims to measure and assess the results of each public administration unit in terms of efficiency of the human resources, satisfaction level of the final users, and transparency of its action. Despite the initial consensus on the necessity to make the decision process in health care visible and transparent, health care organizations find it difficult to demonstrate accountability. The present paper summarizes the evidence on the degree of compliance to the reform requirements and will allow an in-depth understanding of Italian health organizations' attitudes toward accountability. This study will help policymakers understand the degree of acceptance and application of the new reforms and assess whether the law/regulations may be effective drivers for disseminating a culture of transparency and accountability.Keywords: transparency, Italian health care, law/regulations, compliance

The current paper addresses the complex issue of accountability by focusing on Italian public hospitals and teaching hospitals; it aims to analyze Italian health care organizations' strategies for responding to the pressure generated by regulations. In particular, in the last few years, Italian hospitals and teaching hospitals have been obliged to implement or improve their accountability instruments in response to a new regulation (known as the Brunetta reform, Legislative Decree number 150/2009). The Legislative Decree aims to measure and assess the results of each public administration unit in terms of efficiency of the human resources, satisfaction level of the final users, and transparency of its action. Despite the initial consensus on the necessity to make the decision process in health care visible and transparent, health care organizations find it difficult to demonstrate accountability. The present paper summarizes the evidence on the degree of compliance to the reform requirements and will allow an in-depth understanding of Italian health organizations' attitudes toward accountability. This study will help policymakers understand the degree of acceptance and application of the new reforms and assess whether the law/regulations may be effective drivers for disseminating a culture of transparency and accountability.

The changes in the Italian banking system, begun during years nineties and not still concluded, as well as the outcome of the Basel Committee on Banking Supervision's (Basel 2) regarding the international convergence of the regulations governing the capital adequacy, have reopened the debate on the relationship bank-firms; in a more particular way on the necessity to guarantee to SMEs and to the handicraft firms an adapted financial support in order to assure their development and in many cases their survival. The research is aimed to identify the real situation of the bank-small firms relationship, the level of qualitative and quantitative information that the financial enterprises can transfer to the system, the perspectives of survival and development of the same enterprises, considering the changes in action, linked to the future introduction of the new Basel agreement; it currently proposes numerous changes in the actual rules, above all as regard as the credit risk credit and the associated measure of eligible capital for banks. The study, conducted at the moment, on the handicraft enterprises located in the province of Catanzaro (the seat of Calabria local government), take part in the widest debate to a national level. Analogous researches started in other Italian regions testifies a raising interest from scholars and professionals on such topic, not still inquired in systematic way. To carry on the research the questionnaire methodology is been chosen. A medium length, multi-part questionnaire was designed to identify business characteristiques and their relationship with local banks. It contains both open-ended and close-ended questions. This flexible format was used to solicit the most accurate and complete responses from SME.

The recent introduction by the central government of recovery plans (RPs) for Italian hospitals provides useful insights into the recentralization tendencies that are being experienced within the country's decentralized, regional health system. The measure also contributes evidence to the debate on whether there is a long-term structural shift in national health strategy towards more centralized stewardship. The hospital RPs aim to improve the clinical, financial and managerial performance of public-hospitals, teaching-hospitals and research-hospitals through monitoring trends in individual hospitals' expenditure and tackling improvements in clinical care. As such they represent the central governments recognition of the weaknesses of the decentralization process in the health sector. The opponents of the reform argue that financial stability will be restored mainly through across-the-board reductions in hospital expenditure, personnel layoffs and closing of wards, with considerable negative effects on the most vulnerable groups of patients. While hospital RPs are comprehensive and complex, unresolved issues remain as to whether hospitals have the necessary managerial skills for the development of effective and achievable plans. Without also devising an overall plan to tackle the long-standing managerial weaknesses of public hospitals, the objectives of the hospital RPs will be undermined and the decentralization process in the health system will gradually reach a dead-end.