The paper provides a theoretical contribution to public management studies related to public health organizations, starting from the Zappian perspective of organizational economics doctrine. After defining the characteristics of institutional change in the organizational literature, the paper outlines how the management model of public health organizations has evolved. The paper therefore clarifies the variants of the traditional health care organizations in Italy (professional bureaucracy and jus-bureaucracy), noting the reasons for the balance found via the variants in the specialist-functional model. The appropriate changes in the management control systems to support the transition of organizational models are outlined. This framework is based on three complementary key value drivers (organization, interdisciplinarily, technology-intensive). Furthermore, the framework is also aimed at encouraging the evolution of public health organizations toward management by objectives, an approach that is in line with new forms of horizontal interorganizational coordination based on the process of creating value for the patient.
Keywords: Public management, Public healthcare organizations, Management by objectives, Operations management, Leadership