Outsourcing services in the Italian National Health Service: the evaluation of private and public operators

Outsourcing has shown itself worldwide to be a useful tool for improving partnership between private and public companies. The budgetary constraints imposed by the Italian government on health industry are enhancing the urgency to outsource to face costs. Our study deals with the relationship between ASLs (Aziende Sanitarie Locali, the Italian local health authority) and private operators outsourcing in Italy. We studied 44 pharmaceutical companies (with a yearly turnover of about (SIC)6 billion) and 34 ASLs (with about 12 million users) to find out the areas in which they used outsourcing, the amount and the frequency of such investment, their satisfaction and, therefore, their future intentions. We analysed the answers in search for possible relationships between size, frequency of use and other features to uncover a possible convergence between public and private interest in outsourcing. To better evaluate the convergence we analyse and compare satisfaction of both the operators involved in outsourcing (ASL and private operators). We aim to offer a representation of the current state of outsourcing in the Italian Healthcare System and a first indication of possible contrasts in the relationship between public and private partners. The results suggest that public and private operator have a different satisfaction level and in particular their expectations are in contrast whit their satisfaction: ASLs are generally more satisfied than pharmaceutical companies, but expect a considerable reduction of outsourced activities; private companies are less satisfied and provide an increase in these activities. (C) 2014 The Authors. Published by Elsevier B.V.