Chapter 2

• Campania, with strong financial centralism presents a high deficit as percentage of the
Regional Health Fund (14,73%);
• Lazio presents a “formal” financial autonomy of health units because it controls all the
financial resources assigned to hospitals and health units, so it presents a high deficit
(18,54% of Regional Health Funds);
• the lowest deficit value is registered in Regions (like Toscana with 1,52% of Regional
Health Funds) which allocate the highest amount of funds to regional management.
We can finally suppose that regional inefficiency is borne from several aspects:
• first of all, the lack of separation between suppliers and purchasers. This prevents the
transformation of market inputs (such as customer attrition and deficit) into effective
sanctions, such as the discharge of less efficient suppliers;
• second, national LEA indications should be read in two ways: a higher efficiency in allocation
deriving from local social and demographic context; partial adaptation to the historical
spending that demands new balances;
• third, difference from national indication on LEA could depend on the socio-demographic
context or on historical expenditures.
Therefore in the absence of a specific rationalization plan to reduce deficit, the possibility
of utilizing competitive instruments for market rationalization could be lost.
References
Table 4 – Regional Deficits (% of FSR)
REGIONS 2005
Calabria
Campania
Lazio
Piemonte
Sardegna
Sicilia
Toscana
Source: our processing of Ministry of Health data
(5,38%)
14,73%
18,54%
(0,28%)
8,71%
4,44%
1,52%
● Arachi G, Zanardi A (1999), “Sanità alle Regioni, il rischio di due velocità. Restano insufficienti
i meccanismi perequativi” Il Sole 24 Ore.
● Atella V, Mennini FS, Spandonaro F (2004), “Criteri per l’allocazione regionale delle risorse
per la sanità: riflessioni sul caso italiano”, Politiche Sanitarie, anno V, n. 1, gennaiomarzo
2004, Pensiero Scientifico Editore.
● Carbone C et al. (2005), “Rapporto OASI 2005”, Milano EGEA.
● Cuccurullo C, Meneguzzo M (2003), “Ricentralizzazione delle Regioni e autonomia delle
aziende sanitarie. Le tendenze in atto nell’area del federalismo”, Rapporto CEIS Sanità
2003, Italpromo.
● Del Vecchio M (2004), “Il sistema di finanziamento delle aziende sanitarie pubbliche:
[161]
CEIS Health Report 2006