The current financial and debt crisis has accelerated the problem of efficiency and sustainability in health sector. This scenario is characterized by different factors: a drop in tax revenue (Mladovsky, 2012), a growing demand for services (Jack and Powers, 2009), higher patient expectations (Lega, 2013; Toygar and Akbulut, 2014) and expensive medical innovations (Kaplan and Porter, 2011). This situation has given new impetus to reform to save costs in hospital sector (Clemens, 2014). Therefore, hospitals have become important for health reform strategies in many European countries for several reasons. First of all, they are prone to short-term cost control measures (WHO, 2013) and secondly because hospitals are still at the center of the care delivery system (Clemens, 2014). Reforms concern both short-term measures to reduce health costs by leaving the logical structures of the organisation unchanged (Schneider, 2009) and long-term measures to increase the performance of the organisation. However, different analysis, on the reform of the EU countries, have underlined that emphasis on cost containment measures rather than structural redefinition of the hospital sector and its position within the broader healthcare system (Clemens, 2014; Kaplan and Hass, 2015).
From these premise, the current work aims to investigate the following topis: how Spending Review (SR) has impacted on hospitals budget Special attention will be given to the situation of the Italian University Hospitals.
Method
The research was conducted by dividing the work into two main parts. The first, where we define the framework of SR and the second through empirical data. The international comparison was carried out by observing which the leverage and measures were taken to influence budget items. At a second stage, the article describes empirical data analyzed with reference to Italy, and in particular the impact that these measures have caused in Hospital’s budget.
Since 2006, in Italy, we started to talk about Speding review. These measures are important for hospitals from 2012 to 2015, and for this reason the budget data were collected considering that time frame. The sample is composed by 1500 records, which have been analyzed through statistical analyzes, highlighting the possible relationships between data. The analysis is divided into two areas:
- A first analytical part that highlights the characteristics of the observed phenomenon - A second part where highlighted changes in activity due to the spending review over the years.
Takeaway and results
The aim of the research is to highlight the advantages and disadvantages of SR. In particular, we want to highlight the impacts on corporate budgets, with particular reference to the University Italian Hospitals. The results obtained should determine whether or not, cuts are an appropriate measure for budget balances and if they results in a real reduction in total costs. The broad set of data used allows authors to define the current trends and future opportunities and threats related to SR. The objective is to add an in-depth understanding of budget maneuvers and whether management can use these cost cuts to reduce waste and increase productivity.
Spending_Review_in_Healthcare_the_effect_on_budgets_of_Italian_Healthcare_Organizations.pdf 