La misurazione delle performance dei servizi domiciliari e residenziali tra riforme istituzionali ed applicazioni locali

Literature reports contrasting findings concerning the impacts generated by the introduction, driven by legislative reforms, of performance measurement systems in the public sector. Given the ever growing relevance of primary care services within the Italian NHS, this study was aimed at exploring the construction and the potential managerial use of a primary care performance measurement system set down to comply with institutional accountability requirements. This purpose was pursued through an empirical investigation, promoted by the Italian Health Ministry and conducted in collaboration with four local health units, aimed at theoretically developing and empirically testing a performance measurement system based on data contained in the ministerial flows regarding homecare and residential care services. Results demonstrate the feasibility, reliability, and relevance of the proposed system and identify several factors that may facilitate – or obstacle – its actual use.