Is Transparency a ‘Free Lunch’? Evidence from the Italian Local Health Authorities

Paolo Lorenzo Ferrara, Calogero Guccio () and Carla Scaglioni
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Paolo Lorenzo Ferrara: University of Catania
Carla Scaglioni: University of Pisa

Italian Economic Journal: A Continuation of Rivista Italiana degli Economisti and Giornale degli Economisti, 2024, vol. 10, issue 2, No 12, 825-870

Abstract: Abstract The healthcare is often considered one of the sectors most prone to corruption, and transparency policies have been proposed in several countries to fight bribery and corruption. Indeed, the transparency of public bodies potentially plays a relevant role in preventing misbehaviour and favouring accountability. This study contributes to a broader understanding of the role of transparency in the healthcare sector using Italy as a case study. For this purpose, we first built a composite indicator to assess the differences in transparency, performance, and integrity between Italian local health authorities (LHAs) retrieving the administrative data available on their websites. Then, we used both non-parametric method and multivariate regression to explore the relationship between the performance of different expenditure functions (total production costs, administrative costs, and medical and non-medical-related service costs) at the LHA level and the transparency index. Our results show a wide difference in transparency, performance, and integrity among LHAs that does not always follow the classic north–south divide in Italy. In addition, we find results consistent with the idea that transparency is generally associated with a better capability of LHAs in the containment of healthcare expenditure while imposing larger administrative burdens. Overall, reforms promoting transparency impose administrative costs, which policymakers should bear in mind to develop less burdensome transparency measures, as they might not be a ‘free lunch’.

Keywords: Healthcare; Transparency; Corruption; Accountability; Italian NHS; Local Health Authorities; Administrative burdens (search for similar items in EconPapers)
JEL-codes: H30 H41 K20 (search for similar items in EconPapers)
Date: 2024
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Working Paper: Is Transparency a Free Lunch? Evidence from the Italian Local Health Authorities (2021)
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DOI: 10.1007/s40797-023-00229-3

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