Do policies affect management? Evidence from a survey of clinicians of the Italian National Health Service

被引:3
作者
Fattore, Giovanni [1 ]
Numerato, Dino [2 ]
Salvatore, Domenico [3 ]
机构
[1] Univ Bocconi, Dipartimento Anal Polit & Management Pubbl, Via Roentgen 1, I-20136 Milan, Italy
[2] Charles Univ Prague, Fac Social Sci, Prague, Czech Republic
[3] Univ Suor Orsola Benincasa, Naples, Italy
关键词
hospital administration; professional autonomy; regional administration; Italy; cardiology; orthopaedics; PUBLIC MANAGEMENT; LOMBARDY MODEL; DECENTRALIZATION; CARE; GOVERNANCE; SYSTEMS; MANAGERIALISM; CULTURE; GERMANY; REFORM;
D O I
10.1177/09514848211073521
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Since the early 1990s, New Public Management ideas have deeply influenced reforms and their implementation in the Italian NHS. We compare doctors' perceptions about management systems in two Italian regions which differ in the dominant values of the regional political environment. In total 220 doctors, orthopaedists and cardiologists, working in public hospitals in Lombardy and Emilia-Romagna, were surveyed. Doctors in Emilia-Romagna perceived their organization to be more managerially driven in comparison to their colleagues in Lombardy. Doctors from Lombardy perceived their professional freedom to be higher, regardless of their specialization. The divergence of professionals' perception between these two Italian regions, which operate within the same Beveridge model, shows that dominant values of regional politics may have tangible effects on hospital management.
引用
收藏
页码:25 / 33
页数:9
相关论文
共 44 条
[1]   The impacts of decentralization on health system equity, efficiency and resilience: a realist synthesis of the evidence [J].
Abimbola, Seye ;
Baatiema, Leonard ;
Bigdeli, Maryam .
HEALTH POLICY AND PLANNING, 2019, 34 (08) :605-617
[2]   Phasing out market mechanisms in the Italian National Health Service [J].
Anessi-Pessina, E ;
Cantù, E ;
Joninii, C .
PUBLIC MONEY & MANAGEMENT, 2004, 24 (05) :309-316
[3]   Whither managerialism in the Italian National Health Service? [J].
Anessi-Pessina, Eugenio ;
Cantu, Elena .
INTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, 2006, 21 (04) :327-355
[4]   Going down to the local: incorporating social organisation and political culture into assessments of decentralised health care [J].
Atkinson, S ;
Medeiros, RLR ;
Oliveira, PHL ;
de Almeida, RD .
SOCIAL SCIENCE & MEDICINE, 2000, 51 (04) :619-636
[5]   Recentralization within decentralization: County hospital autonomy under devolution in Kenya [J].
Barasa, Edwine W. ;
Manyara, Anthony M. ;
Molyneux, Sassy ;
Tsofa, Benjamin .
PLOS ONE, 2017, 12 (08)
[6]   Quasi-market and cost-containment in Beveridge systems: The Lombardy model of Italy [J].
Brenna, Elenka .
HEALTH POLICY, 2011, 103 (2-3) :209-218
[7]   The analysis of a cardiological network in a regulated setting: A spatial interaction approach [J].
Bruni, Matteo Lippi ;
Nobilio, Lucia ;
Ugolini, Cristina .
HEALTH ECONOMICS, 2008, 17 (02) :221-233
[8]   Reforming medical governance in Europe. What is it about institutions? [J].
Burau, Viola ;
Wilsford, David ;
France, George .
HEALTH ECONOMICS POLICY AND LAW, 2009, 4 (03) :265-281
[9]   An organizational culture for all seasons? How cultural type dominance and strength influence different performance goals [J].
Calciolari, Stefano ;
Prenestini, Anna ;
Lega, Federico .
PUBLIC MANAGEMENT REVIEW, 2018, 20 (09) :1400-1422
[10]   The 'Lombardy model': Subsidiarity-informed regional governance [J].
Colombo, Alessandro .
SOCIAL POLICY & ADMINISTRATION, 2008, 42 (02) :177-196