Managing Italian Healthcare Services in a Partial Competition System: the Viewpoint of the Office

Beginning in the early 1990s, reform of the Italian healthcare Servic (NHS) led to a controlled competition system. Consequently, managers had to face a new institutional framework, one which was characterized by the following elements: citizens' choice of the healthcare organizations to deliver the services they need; the integration of public healthcare organizations' supply with private accredited organizations; the distinction between producing and purchasing organizations. Consequently, management of the purchasing and marketing functions can have a key role in the new situation. By presenting an analysis of national, regional, and local regulations and case analysis, this paper points out the main aspects concerning procurement policy in the Italian NHS. The implications for the internal market mechanism, the Purchasing and Marketing Office's role, and the activities implemented in order to contribute to a wide range of decisions are considered.