Macinati Manuela S
Università Cattolica del Sacro Cuore, Rome, Italy.
Int J Health Plann Manage. 2008 Jan-Mar;23(1):21-36. doi: 10.1002/hpm.902.
Over the last decade, outsourcing has become one of the major issues in health care. Two major concerns are related to public health care outsourcing practice. The first one involves the suitability of the outsourcing strategy in the public sector, principally with reference to the outsourcing of essential clinical services. The second one relates to the actual benefits of the outsourcing practice in health care, in terms of cost reduction and increasing efficiency. This paper aims to contribute to the debate and literature on outsourcing through a national survey carried out in the Italian National Health Service. In order to achieve the research objective, a questionnaire was developed and, after a pilot test, it was mailed to all Italian public providers. The total response rate was around 42%. Results showed that outsourcing is a widespread phenomenon within health care, especially in the ancillary services area. Moreover, results showed many criticalities of the outsourcing practice in the Italian health-care sector. On the one hand, criticalities concerned the reasons for outsourcing, the characteristics of the outsourced services and the management of the relationship with the vendor. With reference to essential clinical service, outsourcing, as currently managed by health-care providers, may potentially weaken their ability to reach its own objectives. On the other hand, criticalities related to respondent-perceived benefits. Despite the overall positive outsourcing experience expressed in the survey, the results on perceived benefits showed that the effects of outsourcing did not always align to managers' expectations, especially in the cost containment and efficiency area.
在过去十年中，外包已成为医疗保健领域的主要问题之一。与公共医疗保健外包实践相关的主要有两个问题。第一个问题涉及公共部门外包战略的适用性，主要是指基本临床服务的外包。第二个问题涉及医疗保健外包实践在成本降低和提高效率方面的实际效益。本文旨在通过对意大利国家医疗服务体系进行的全国性调查，为有关外包的辩论和文献做出贡献。为了实现研究目标，设计了一份问卷，并在进行试点测试后，将其邮寄给所有意大利公共服务提供商。总回复率约为42%。结果表明，外包在医疗保健领域是一种普遍现象，尤其是在辅助服务领域。此外，结果还显示了意大利医疗保健部门外包实践存在的许多关键问题。一方面，关键问题涉及外包的原因、外包服务的特点以及与供应商关系的管理。对于基本临床服务，目前由医疗保健提供商管理的外包可能会削弱其实现自身目标的能力。另一方面，关键问题与受访者感知到的效益有关。尽管调查中总体上表达了对外包的积极体验，但关于感知效益的结果表明，外包的效果并不总是符合管理者的期望，尤其是在成本控制和效率方面。
