A note on standard costs criteria for allocating the Italian national health fund to Regions

Journal title ECONOMIA PUBBLICA
Author/s Alessandro Petretto
Publishing Year 2014 Issue 2014/2
Language English Pages 17 P. 5-21 File size 240 KB
DOI 10.3280/EP2014-002001
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The funding of National Health Service in Italy follows a top-down two stages decentralized system, according to which the central Government feeds the National health-fund with specific taxes and distributes it among Regions. Further, each Region funds the so called Essential levels of Assistance (LEA) expenditures of its local health authorities (Aziendesanitarie locali, ASL). This mechanism pursues equity aims, but it can be, as well, efficiency enhancing if based on standardized quantities, hence on a fixed-price type transfer, i.e. established ex-ante independently of actual expenditures and costs. This note provides a technical analysis of possible allocation criteria with this purpose, and, at the same time, coherent with the procedure established by D.L. 68/2011. The aim is at establishing feasible analytical procedures for combining both equity and cost-efficiency concerns in defining the distribution formula. The idea is to introduce in the latter some incentive elements, even if only as signals, for boosting Regions to control unitary costs of health-care services, besides to produce and provide adequate levels of them.

Keywords: National Health Service, standard costs, allocation criteria, costefficiency.

Jel codes: I12, H51, H77

  1. Abbafati C. e Spadonaro F. (2011). Costi standard e finanziamento del Servizio Sanitario Nazionale. Politiche sanitarie, 12(2): 45-55. DOI: 10.1706/930.10198
  2. Caruso E. and Dirindin N. (2012). Health Care and Fiscal Federalism: Paradoxes of Recent Reforms in Italy. Politica Economica, 28(2): 169-196. DOI: 10.1429/38640
  3. Dirindin N. (2010). Fabbisogni e costi standard in sanita: limiti e meriti di una proposta conservativa. Politiche Sanitarie, 11(4). DOI: 10.1706/555.6605
  4. Mapelli V. (2010). Se il costo standard diventa inutile. www.lavoce.info, 8.10.2010.
  5. Mapelli V. (2012). Il sistema sanitario italiano. Bologna: il Mulino. Pammolli F. e Salerno N. (2010). I numeri del federalismo in sanita, benchmarking e standard su profili di spesa per eta. CERM working paper No. 3.
  6. Pammolli F. e Salerno N. (2011). Il riparto del FSN per il 2011: much ado about nothing? CERM working paper No. 1.
  7. Petretto A. (2013a). On the Fuzzy Boundaries Between Public and Private in Health-Care Organization and Funding systems. EconPapers, Rivista di Politica economica, 1: 327-370.
  8. Petretto A. (2013b). Need Equalization Transfers and Productive Efficiency of Local Governments. Rivista Italiana degli Economisti, Journal of the Italian Economic Association, 1: 25-46.
  9. Pisauro G. (2010). Retorica e realta nella determinazione dei fabbisogni standard nella sanita. www.nelmerito.com, 22.10.2010.

Alessandro Petretto, A note on standard costs criteria for allocating the Italian national health fund to Regions in "ECONOMIA PUBBLICA " 2/2014, pp 5-21, DOI: 10.3280/EP2014-002001