4206.0: Tuesday, October 23, 2001 - Table 6

Abstract #24216

MBO and beyond. Evolution of the management in the Italian Health Care System

Nicola Ricci, MD, Dipartimento della Prevenzione, Segretario Regionale SNOP Molise, ASL 2 Pentria, Isernia, Largo Cappuccini, Isernia, Italy, 0039 0865 442576, mfric@tin.it, Michelangelo Bonomolo, Direttore Generale, ASL 3 Centro Molise, Via U. Petrella, 1, Campobasso, 86100, Italy, and Dario Menna, Novartis, Pesche, 86170, Italy.

Substancial innovations have been introduced by recent labour contacts of Italian doctors and Major Reform Act (the third one since 1992) of the National Health System. Both provide managers of NHS’ Agencies with the opportunity of implementing managerial tools and strategies toward achieving patient satisfaction as well as cost-effective management. A rewarding system (MBO) is introduced by recent labour contract for doctors whose ability in improving health care standards may be rewarded through pay merit and career advancement. On the other hand doctors have been forced to choose between: a) working in the NHS and progress through career being allowed to do private practice inside public settings or b) working both in NHS and private setting outside Public Hospitals. In this instance they receive no budget, less salary and cannot progress through professional career. Budgetting, department organization, organizational autonomy, entrepreneurial skills are specific targets assigned to General Managers of Local Health Units in order to reduce costs and stimulate competition between Public and Private Providers. The choice of introducing effective management tools through MBO system may contribute to shorten the phase of transition of the Italian NHS. The MBO system provides an objective tool for periodical and comprehensive performance appraisal of doctors as well as of General Managers themselves. See www.snop.it

Learning Objectives: a) The participants will learn how Local Health Acencies in the Italian Health Care System try to improve performance by using management tools such as MBO system to increase productivity of doctors; 2) The participants will also obtain insights about newly reformed Italian NHS; 3) In listening to this report the participant will recognize the obstacles and the difficulties the Managers have to face in operating in a highly politicized environment of a never-ending transition phase of Italian NHS.

Keywords: Health Care Reform, Management

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA