Il ruolo delle Aziende Sanitarie Locali nella gestione della spesa ospedaliera alla luce di un indagine empirica sulla Asl di Como

This paper tries to analyse the way of financing hospital admissions in Lombardy Region. With the help of a case study, it attempts to verify if the governance model approved in 1997, which enables local Health Authority (ASL) to contract with providers about number, typology and prices of hospital admissions, is achieved. The findings show that till 2003 it was the Region who controlled for these parameters and who regulated hospital expenses, while ASL had a marginal position. If Region doesn’t let more autonomy to ASL, and continues financing deficit ex-post, it will be very difficult to program and control hospital expenses.