IL RUOLO DELLA FARMACIA TERRITORIALE NEL CONTESTO SANITARIO ITALIANO: UN’ANALISI DELL’ORIENTAMENTO ECONOMICO-MANAGERIALE E DELLA ATTITUDINE AL CAMBIAMENTO

Background: In many European countries the community pharmacies have been redefining their role, facing the institutional changes and the national healthcare service design. Thus, most of the literature on practice change focus on the international experience analyzing how pharmacy practice has been affected by a different mix of services, a different relation with other healthcare actors, a different range of objectives to achieve. The literature shows a lack of contributions when referring to the Italian experience. Aims: The aim of the PhD dissertation is to investigate if the community pharmacy in Italy could be agent of change. Thus the abilities of the pharmacies to understand the changing environment, their managerial orientation and attitude to take responsibility for health outcome are analyzed. Method: The research study is based on literature review and on a survey conducted among a sample of 719 community pharmacies from all over the country. Data were collected through a questionnaire steaming from both the organizational theory, and the management accounting theory. Data were analyzed according to both descriptive statistics and regressions, using SPSS-19 program and MatLab one. Results: Responses from 719 director of pharmacies were obtained. Respondents have limited awareness of the context, and actually services provided are heterogeneous and not widely consistent with the aims of the 2009 reform law. There is a positive willingness to extent the professional role, and this would require a different information system and level of abilities and knowledge. Findings allow to support that accounting information systems and the information holders (i.e., accountants, stock inventories, etc.) have an important role do determine the community pharmacies managerial orientation. Furthermore, the ability to change is mainly associated to the perception of the professional role that the respondents has. Thus, community pharmacies will be able to undertake relevant changes as pharmacists consider services’ delivery a part of their profession. Conclusion: The study suggests how the ability of the community pharmacies’ director to change practice requires: the development of professionals’ awareness about the context characteristics, the identification of the extension areas of their role, the extension of the data-set and information system to improve the decision making process, and help to develop a strategic vision of the practice change. These conclusions contribute to the literature on pharmacy practice, and are relevant for policy makers, considering the liberal economic policies that many countries have defined.