In recent years in Italy, as in other European countries, profound changes have been introduced in health care at both the central and the regional levels. Most of them were oriented towards a shift from “hospital-centred” healthcare to healthcare based more on territorial services. This...

This paper proposes an integrated quantitative benchmarking approach for the measurement of the performance of Local Health Authorities (LHAs). It is based on a sound balanced scorecard approach developed and implemented in the Tuscany Region by the Management and Health Laboratory of...

Background Tuscany Region has implemented a multidimensional system to assess the performance of all Local Health Authorities (LHAs), based on over 130 indicators classified in 6 dimensions in benchmarking. A study was carried out to use the results of the evaluation performance system to...

The problem of gaming in performance evaluation systems is a known phenomenon (Bevan, 2006, Bevan Hood, 2006) that can take place especially when there are economic incentives related to specific targets. In all Tuscan Local Health Authorities (LHAs) and Teaching Hospitals (THs) a...

The Tuscan health care system strives to foster cooperation among the various organizations that provide services. Government authorities therefore believe it is important to plan and develop a transparent system capable of monitoring the economic results of the region’s 16 public health...

The aim of this article is to present a hardware and software architecture that shows how to combine different open source technologies in order to realize an efficient system to collect and analyze data from a web survey. The framework presented has been used, in the context of the Performance...

The designing of a performance measurement system usually involves several players, the number and the role of the players in building new performance measurement tools depending on the features affecting the type of organization. Among them, health care units can be considered as some of the...

Governance systems which are based on assumptions of purposive-rational action have received significant criticism. For example recent quality and performance frameworks of the English NHS have tended towards incentives and sanctions, and have been critiqued in terms of both the logic on which...