Abstract

In Italy, among routines and innovative processes, the management and assessment of efficiency, effectiveness and service quality in the health sector still lags far behind despite the conspicuous and growing resources invested. At least partially, such a discrepancy depends on some events that occurred in the sector in the last 20 years: devolution and formal privatisation processes brought about some positive boosts, but also some significant turbulence and conflict. In this complex context, we are developing new controlling and supporting tools, which go beyond management control and customer satisfaction, in order to embrace the clinical governance pattern, a general openness and the multistakeholder assessment. In the policy agenda, the following issues become crucial: quality, security and adequateness of the health care sector, health promotion and preventive information, coordination of institutional centralised and decentralised functions.