Healthcare facilities monitoring is fundamental to learn about the state of a health system. The monitoring of activities and performances of healthcare facilities allows for objective analysis and evaluation of their performance. These practices make it possible to understand their strengths and weaknesses and enable the various actors involved in health management to work synergistically to improve them. Currently, there are several agencies that monitor health care at a local or individual facility level. In 2024 Agenas, tasked by the Italian Ministry of Health, generated the first report that analyzes with a multidimensional approach the performance of Italian Hospitals at the national level, named "Monitor n.49: Valutazione della performance delle aziende ospedaliere pubbliche". In this report, 53 Hospitals and University Hospitals, located across 15 regions were selected due to the easy availability and comparability of their data. The performance areas analyzed for each Hospital are: Accessibility, Governance of Organizational Processes, Staffing and Investments. Each area is divided into subareas (16 in total) to which belong specific indicators (40 in total). With the data provided by Agenas, a comparison was made among three triplets of regions, grouped by population and number of Hospitals and University Hospitals in their territory. For each triplet, the regional health service was described and each area was compared to assess its performance from 2019 to 2023. This analysis was combined with the regional average duration of the general managers of Hospitals and University Hospitals. The analyses have shown that regions that delegate some health care functions have on average higher performances, in contrast to those where health care is managed directly by the region. In addition, it appears that the discontinuity of the general director tenure does not particularly affect performance results. Finally, the areas covered in this performance monitoring did not experience drastic declines due to the effects of the COVID-19 pandemic. Agenas launched a multidimensional, national health performance evaluation with Monitor 49. Updates to the methodology and indicators have already been made in Agenas’ following report, but further actions could be taken. Specifically, it would be useful to broaden and further standardize the criteria of indicator, expand the types and number of Hospitals covered by these assessments, and extend the monitoring to regions currently excluded.
Il monitoraggio delle strutture sanitarie è un processo fondamentale per conoscere lo stato di un sistema sanitario. Monitorare le attività e l’andamento delle strutture sanitarie consente di effettuare analisi e valutazioni oggettive delle loro performance, al fine di comprenderne i punti di forza e le debolezze e consentire ai vari attori coinvolti nella gestione sanitaria di lavorare sinergicamente per migliorarle. Attualmente ci sono diversi enti che si occupano di monitorare la sanità a livello locale o di singola struttura. Nel 2024 Agenas, incaricato dal Ministero della Salute, ha prodotto il primo documento che analizza con un approccio multidimensionale la performance delle Aziende Ospedaliere (AO) a livello nazionale: “Monitor n.49: Valutazione della performance delle aziende ospedaliere pubbliche”. In questo documento sono state selezionate 53 tra AO e AO Universitarie (AOU) divise su 15 regioni per via della facile reperibilità e confrontabilità dei loro dati. Le aree della performance analizzate per ogni struttura sono: Accessibilità, Governance dei Processi Organizzativi, Personale e Investimenti. Ogni area è suddivisa in sub-aree (16 in tutto) a cui appartengono specifici indicatori (40 in totale). Con i dati forniti da Agenas è stato effettuato un confronto fra tre triplette di regioni, raggruppate per numero di abitanti e numero di AO e AOU presenti nel loro territorio. Per ogni tripletta è stato descritto il servizio sanitario regionale ed è stata confrontata ogni area della performance dal 2019 al 2023 per valutarne l’andamento. A questa analisi è stata associata la durata media regionale dei direttori generali delle AO e AOU. Da queste analisi è emerso che le regioni che delegano alcune funzioni della sanità hanno mediamente valori di performance più alti a differenza di quelle in cui la sanità è gestita direttamente alla Regione. Inoltre, risulta che la discontinuità dell’attività del direttore generale non incida particolarmente sui risultati della performance. Infine, le aree interessate in questo monitoraggio della performance non hanno subito cali drastici dovuti agli effetti della pandemia da COVID-19. Con il Monitor 49 Agenas ha dato il via a una valutazione della performance sanitaria multidimensionale e nazionale. Alcuni aggiornamenti alla metodologia e agli indicatori sono già stati fatti nel report successivo, ma altre azioni possono essere intraprese. Nello specifico sarebbe utile ampliare e uniformare i criteri della costruzione degli indicatori, estendere le tipologie e il numero di strutture interessate da queste valutazioni ed estendere il monitoraggio anche alle regioni attualmente escluse.
Monitoraggio della performance delle Aziende Ospedaliere Pubbliche in Italia: confronto regionale e analisi dei dati Agenas dal 2019 al 2023
BRACCIALI, DANIELE
2024/2025
Abstract
Healthcare facilities monitoring is fundamental to learn about the state of a health system. The monitoring of activities and performances of healthcare facilities allows for objective analysis and evaluation of their performance. These practices make it possible to understand their strengths and weaknesses and enable the various actors involved in health management to work synergistically to improve them. Currently, there are several agencies that monitor health care at a local or individual facility level. In 2024 Agenas, tasked by the Italian Ministry of Health, generated the first report that analyzes with a multidimensional approach the performance of Italian Hospitals at the national level, named "Monitor n.49: Valutazione della performance delle aziende ospedaliere pubbliche". In this report, 53 Hospitals and University Hospitals, located across 15 regions were selected due to the easy availability and comparability of their data. The performance areas analyzed for each Hospital are: Accessibility, Governance of Organizational Processes, Staffing and Investments. Each area is divided into subareas (16 in total) to which belong specific indicators (40 in total). With the data provided by Agenas, a comparison was made among three triplets of regions, grouped by population and number of Hospitals and University Hospitals in their territory. For each triplet, the regional health service was described and each area was compared to assess its performance from 2019 to 2023. This analysis was combined with the regional average duration of the general managers of Hospitals and University Hospitals. The analyses have shown that regions that delegate some health care functions have on average higher performances, in contrast to those where health care is managed directly by the region. In addition, it appears that the discontinuity of the general director tenure does not particularly affect performance results. Finally, the areas covered in this performance monitoring did not experience drastic declines due to the effects of the COVID-19 pandemic. Agenas launched a multidimensional, national health performance evaluation with Monitor 49. Updates to the methodology and indicators have already been made in Agenas’ following report, but further actions could be taken. Specifically, it would be useful to broaden and further standardize the criteria of indicator, expand the types and number of Hospitals covered by these assessments, and extend the monitoring to regions currently excluded.| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/239770