Assessing the Financial Performance of Italian’ Teaching Hospitals: Are They Sustainable?

Abstract

The topic of efficiency and efficacy in the public sector has, in the last few years, placed itself at the centre of political and doctrinal debate. All sectors of public intervention have shown a growing interest in monitoring performances with the intent to get better margins of functionality. Research on performance measurement has attracted significant interest from both practitioners and researchers, particularly in the healthcare sector (van der Geer, van Tuijl, & Rutte, 2009). In this scenario, Teaching Hospital (TH) that are conceived as healthcare structure with a threefold mission that includes care, teaching and research have higher costs than non-THs (Culbertson, 1996; Langabeer, 1998; Kassirer, 1999; Taylor et al., 1999; Langabeer, 2006). Moreover, the international literature highlights some factors that threaten THs such as governance complexity, coordination issues and current lack of efficiency (Liu, Forgione, & Younis, 2012).

Nuti et al. (2016) have recently explored the case of Italian TH by using 27 indicators of overall performance and analyzing how THs behave homogeneously regarding performance results with substantial differences with respect to general hospitals (GHs). This work aims to explore the actual state of Italian THs in the light of the Regional Health Systems in which they operate and considering the recent public and healthcare expenditure dynamics. Early results provide evidence for policymakers and managers in defining specific policies and actions in order to improve the quality of care within the regional network of hospitals, where UHs play a specific and strategic role, and in order to pursue their specific mission.

Keywords: Teaching Hospitals; AHC; MHC

JEL Classification: M10; M20