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the contract conditions are previously determined. Lastly, the dynamic purchasing system, albeit with some differences, has many similarities with the PA Electronic Market (MEPA). In this regard, it is also worth recalling that the DPR 101/02 8 , the basic law for the MEPA, is still in force and that use of the MEPA on the part of the Administrations belonging to the NHS is growing (see the chapter on the MEPA). 3.3.5 2005 Activities and Results of the Program Pertaining to the National Health System (NHS) 3.3.5.1 The Framework Contracts Coherently with the overall strategy of the Program, the year 2005 has been characterized by a significant re-balancing of the services offered by the Program, by the strengthening of the framework contract system, the consolidation of the PA Electronic Market, the development of consultancy activities supporting Public Administration and the improvement of electronic tender procedures. Altogether, the results that have been achieved are extremely satisfactory. This is not only due to the complementary offer of services made available to Public Administration, but also to Consip’s ability to present itself as the main interlocutor of the Administration on public procurement issues. In 2005 the activation of several new framework contracts and the renewal of exhausted/expired contracts registered a significant increase in both the areas of covered expenditure 9 and potential savings 10 . The total volume of expenditure 11 generated through the framework con- Chart. 1 – Main Program Indicator Trends 4.280 2001 8.473 15.036 5.651 COVERED EXPENDITURE (million ¤) Composite growth rate 2001 vs 2005 +33% 13.668 1.390 2.308 3.196 POTENTIAL SAVINGS (million ¤) CONTRACTS GENERATED EXPENDITURE (million ¤) Composite growth rate 2001 vs 2005 +34% 8 The DPR (President of the Republic Decree) n. 101 of April 4, 2002, introduced new purchasing processes based on innovative technologies. Apart from the purchasing instruments already used by the Public Administration (private negotiation, open tender, private tender), it introduces the PA Electronic Market – only for purchases below the EU threshold – and the Electronic Tender to handle online the entire tender procedure for purchases below and beyond the EU threshold. 948 2.306 [177] 294 1.044 1.959 932 945 2002 2003 2004 2005 2001 2002 2003 2004 2005 2001 2002 2003 2004 2005 CEIS Health Report 2006
CEIS Health Report 2006 tract system remained at the same level as the previous year. Chart 1 depicts the general trends of covered expenditure, potential savings and expenditure generated through the framework contract system, from the starting of the Program through to the end of 2005. In 2005 the total value of covered expenditure reached € 13,7 billion, far more over the forecasted value of € 12,5 billion, with an average unit cost reduction corresponding to 16,7%. Issued orders registered a constant growth trend that confirms the results achieved from the beginning of the Program to this day, despite the Program’s scarce activity registered in 2004 (due to the publication of DPCM n. 325 only at the end of the year). 2005 NHS covered expenditure reached € 6.288 million. In the course of the year, two new significant health expenditure initiatives were implemented, one on “adult incontinence” and the other on “integrated management of electro-medical instruments”. Particular attention needs the NHS Administrations’ participation in the Program on the Rationalization of Public Spending, in terms of volume of orders issued through the framework contract system. In fact, the contracts generated expenditure corresponds in 2005 to € 185 million (vis à vis a total generated expenditure of € 945 million). This result is significantly greater than that of 2004. As already mentioned the year 2004 was characterized by the suspension of new tenders (waiting for the publication of DPCM n. 325) and the gradual expiry of the framework contracts available. On the opposite, 2005 was focused on the launching of new tenders, and relaunching of the entire framework contract system, that took the better part of the year. Thus goods and services were available only during the second half of the year. Moreover, through the year several activities were carried out aimed at ensuring the abidance with the procedural transparency and accessibility criteria of the Program, in addition to the strengthening of cooperation with the watchdog and control Authorities in order to ensure full compliance with market regulations. 9 The term covered expenditure refers to the annual expenditure related to the goods and services that are object of the framework contracts that have been implemented. A single category of goods/services may be object of more than one framework agreement, providing cover of the range offered through different tender modalities and timing. 10 The unit cost percentage reduction amounts to the average discount obtained, at the end of the tender procedure, also in relation to average inflation and to prices currently paid by Administrations for goods and services that are comparable to those object of the framework contract, both in terms of quality and supplier service levels. A statistical study, carried out in cooperation with the MEF, ISTAT (National Institute on Statistics) and Consip has produced an accurate identification of average prices paid by the PA for some product categories, highlighting the accuracy of the values that had been estimated in terms of potential savings. The total potential savings figures take into account also the benchmark effect for those PA that have bought through the framework contract system and thus must refer to the contracts’ price and quality parameters when acquiring comparable goods. 11 By framework contract-generated expense, referring to a specific active contract, one may be referring to one of the following: • cost of ordered goods/services; • order value for those framework contracts that deal with rentals and leasing; • traffic value handled through the framework contract (e.g. in the case of fixed-line telephone services). [178]
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CEIS Health Report 2006 Management
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CEIS Health Report 2006 Management
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Index Report Presentation by Pagane
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1.6 - The Regional Primary Care Agr
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Chapter 3 - Efficiency 3.1 - The Ef
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3.8 - Private Health Insurance and
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Ceis - Sanità Report presentation
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Warning The figures in the volume f
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CEIS Health Report 2006 stantial, i
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CEIS Health Report 2006 If, therefo
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CEIS Health Report 2006 Cross-check
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CEIS Health Report 2006 over € 6.
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CEIS Health Report 2006 made; final
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CEIS Health Report 2006 Although th
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CEIS Health Report 2006 Aside from
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CEIS Health Report 2006 Regulations
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CEIS Health Report 2006 especially
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Chapter 1 Health expenditure and fu
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CEIS Health Report 2006 The questio
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CEIS Health Report 2006 Table 1 - T
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CEIS Health Report 2006 Figure 3 -
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CEIS Health Report 2006 ciated with
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CEIS Health Report 2006 ● OECD (2
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CEIS Health Report 2006 the phenome
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CEIS Health Report 2006 Table 3 - R
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CEIS Health Report 2006 The indicat
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CEIS Health Report 2006 References
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CEIS Health Report 2006 All the var
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CEIS Health Report 2006 Diagram 1 -
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CEIS Health Report 2006 1.4 - Pharm
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CEIS Health Report 2006 % Pharmaceu
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CEIS Health Report 2006 The second
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CEIS Health Report 2006 tion of res
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CEIS Health Report 2006 Table 4 - R
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CEIS Health Report 2006 1.5 - The r
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CEIS Health Report 2006 southern Re
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CEIS Health Report 2006 1.5.5 Absor
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CEIS Health Report 2006 For day hos
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CEIS Health Report 2006 There is co
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CEIS Health Report 2006 1.6 - The r
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CEIS Health Report 2006 the Primary
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CEIS Health Report 2006 Table 1 - T
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CEIS Health Report 2006 As can be o
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CEIS Health Report 2006 Another int
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CEIS Health Report 2006 Some signif
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CEIS Health Report 2006 1.7.5 Concl
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CEIS Health Report 2006 [114]
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Introduction Public deficit in the
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CEIS Health Report 2006 The cumulat
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CEIS Health Report 2006 tegies of i
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CEIS Health Report 2006 gest that t
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Page 164 and 165: hospital stays has reduced the aver
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Page 168 and 169: CMS = f(COST, CMP, PL, RC, DM , PME
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Page 194 and 195: cooperation to achieve the developm
Page 196 and 197: However, to manage a multi-site hos
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Page 216 and 217: [217] CEIS Health Report 2006 Table
Page 218 and 219: Vaginal childbirth Some synthesis i
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Page 222 and 223: dental work, the purchase or rental
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● OECD (2004), “Towards High -
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4.1 - Equity in the italian healthc
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Table 2 - Association indexes betwe
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4.1.5 Structure of health expenditu
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Table 9 - Regional distribution of
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strophic payments; moreover, the se
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● Doglia M, Spandonaro F, “Il p
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CEIS Health Report 2006 (i represen
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CEIS Health Report 2006 sence of di
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CEIS Health Report 2006 -0,0030, wh
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CEIS Health Report 2006 Although co
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5.1 - The median age at death for m
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causes and the median age at genera
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in the South and Islands, not only
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5.2 - Analysis of avoidable deaths
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population of Italian citizens acco
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We wish to underline the mortality
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Diagram 4 - % composition of years
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5.2.4 Comments The results of the a
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among whites and blacks,1979-1989
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Figure 1 - Division % of the quota
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Figure 3 - Pharmaceutics expenditur
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Table 3 - Gross fixed investments i
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Table 4 - Share of medical device w
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age dimension of enterprises (90 em
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BOX 2: National Medical Device Clas
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maceutiche in Italia (1997-2001)”
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5.4 - Mobility of italian patients
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Authority (ASL) will be charged for
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43.950.716,00. At this stage, if yo
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esting data are certainly provided
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have carried out economic and stati
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[295] CEIS Health Report 2006
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✔ DE POUVOURVILLE GÉRARD Researc
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✔ MENNINI FRANCESCO SAVERIO Degre
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✔ SCHWEIGER ARTURO Health Economi
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