De Nicola Arianna, Gitto Simone, Mancuso Paolo, Valdmanis Vivian
Dipartimento di Ingegneria dell'Impresa, Università di Roma Tor Vergata, Rome, Italy.
University of the Sciences of Philadelphia, Health Policy Program, Philadelphia, Pennsylvania, USA.
Int J Health Plann Manage. 2014 Jan-Mar;29(1):e48-e63. doi: 10.1002/hpm.2183. Epub 2013 Apr 25.
Over the past twenty years, important changes in the Italian health system have led to different approaches in organizing, delivering and financing health services throughout the country's regions. In this paper, we assess the impacts that such changes have had on health efficiency. The analysis performed here is in two stages. In the first stage, healthcare efficiency is measured via bootstrapped Data Envelopment Analysis. In the second stage, the impacts of organizational and environmental variables on efficiency are investigated. Our results highlight that the organizational model adopted by the Lombardia region allows for the best results in healthcare efficiency in Italy. A process of administrative decentralization from the regional governments to local health units appears to be a source of inefficiency. Finally, patient mobility has a significant impact on healthcare efficiency.
在过去二十年中，意大利医疗体系发生了重大变化，导致该国各地区在医疗服务的组织、提供和融资方式上出现了差异。在本文中，我们评估了这些变化对医疗效率的影响。此处进行的分析分为两个阶段。在第一阶段，通过自举数据包络分析来衡量医疗效率。在第二阶段，研究组织和环境变量对效率的影响。我们的结果表明，伦巴第大区采用的组织模式在意大利医疗效率方面取得了最佳成果。从地区政府到地方卫生单位的行政分权过程似乎是效率低下的一个根源。最后，患者流动对医疗效率有重大影响。
