 Lessons from the Italian NHS retrenchment policyFrancesco Longo Health Policy, 2016, vol. 120, issue 3, 306-315 Abstract: In policymaking, implementation is often more critical than design. A variety of policy implementation frameworks can be used to explain implementation gaps and shifts. Each research stream suggests some solutions to prevent shortfalls. We have assessed two of these implementation strategies in the recent INHS (Italian National Health Service) retrenchment policies: (1) centralizing to rapidly cut expenditures, (2) effective management as an output- and not input-based system. The implementation of the INHS retrenchment policy has been very difficult though effective in a short period of time. A multi-level governance structure was put in place that assigned different but clear roles, powers and responsibilities to central and regional governments and public health care organizations. The entire policy was based on an exclusive input-based approach to introduce opacity in the system's prioritization processes. We most likely need to reconsider the identification of crucial implementation drivers in the public realm. Keywords: Health care reforms; Retrenchment; Spending review; NHS; Implementation strategies; Italy (search for similar items in EconPapers) Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:120:y:2016:i:3:p:306-315 DOI: 10.1016/j.healthpol.2016.02.001 Access Statistics for this article Health Policy is currently edited by Katrien Kesteloot, Mia Defever and Irina Cleemput More articles in Health Policy from Elsevier |
Is your work missing from RePEc? Here is how to contribute.
Questions or problems? Check the EconPapers FAQ or send mail to .
EconPapers is hosted by the
School of Business at Örebro University.