Le innovazioni nei sistemi di programmazione e controllo

Translated title of the contribution: [Autom. eng. transl.] Innovations in programming and control systems

Research output: Chapter in Book/Report/Conference proceedingChapter


[Autom. eng. transl.] The introduction of programming and control systems (P & amp; C) has represented, for healthcare companies, one of the most important vectors of change (Casati, 2000; Francesconi, 2003; Del Vecchio, 2008; Bergamaschi and Lecci, 2009). The planning and management control system in public companies that provide services with a high professional content and the tools for concrete implementation of the control system were initially underestimated, but, starting from the nineties, the NHS has been the subject of a complex series of reform measures, the implementation of which, at company level, has resulted in the introduction and development of a set of "managerial" tools for corporate governance (Lecci and Longo, 2004). In fact, the greatest number of experiments and introductions of programming and control tools (budget systems, analytical accounting and reporting) dates back to that period and it is always at that time that the healthcare companies have started a policy of development of professional and technological resources aimed at supporting the new governance logic (Vendramini, 2004). In their most authentic interpretation, planning and control systems are configured as "the formal routines and procedures based on information that managers use to maintain or modify the organization's behavior in carrying out its activity" (Simons 1995: p.5). According to this interpretation, the programming and control systems constitute a model of management behavior, therefore they represent organizational variables that directly influence the behavior of the various actors within a company (Airoldi et al. 1994). The purposes that literature assigns to programming and control systems can be multiple and at least in part conflicting (Anton, 1964; Amigoni, 1995; Casati, 2000): (i) enhancement and articulation of strategic programs; (ii) accountability; (iii) guidance and motivation of managers; (iv) coordination and integration; (v) communication; (vi) evaluation and control; (vii) learning and training. Some distinctive features present in healthcare companies (Bergamaschi, 2004), make the application of these tools in healthcare quite peculiar, in particular public healthcare companies (Anessi Pessina, 2002; Young, 1993): • have the purpose of satisfying the health needs of the population, even if in conditions of economic sustainability; • they operate in a context other than the market and therefore sell their services through transactions other than the typical exchange; • they are characterized by non-standard processes, also in the face of the significant professional autonomy of doctors and the necessary personalization of services; • they are characterized by a strong differentiation of activities and by high degrees of specialization which determine significant needs for integration in order to respond to the needs of users; • they are part of a National Health Service and therefore are part of a more complex group, whose holding is clearly identifiable with the Region. Despite the positive aspects described above, the planning and control systems of public health organizations are still in the evolution phase and still present significant critical elements (Bergamaschi and Lecci, 2008; Devine et al., 2000). After a period of strong diffusion towards the introduction of "strictu senso" programming and control logics and tools (Anessi Pessina and Pinelli, 2003), that is as a tool for accountability and internal coordination, a series of critical issues have arisen in healthcare companies linked to the introduction of these tools: use in an eminently bureaucratic logic, substantially disconnected
Translated title of the contribution[Autom. eng. transl.] Innovations in programming and control systems
Original languageItalian
Title of host publicationL'aziendalizzazione della sanità in italia 2011 Rapporto OASI
Number of pages28
Publication statusPublished - 2011


  • programmazione e controllo


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