About
90
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Introduction
I'm professionally active in Switzerland (www.supsi.ch) and in Italy (www.cergas.unibocconi.it and www.sdabocconi.it).
Domains of research: health professions regulation; healthcare labour market; human resource management in health organisations; private voluntary health insurance; Swiss health insurance; compared health policy.
Additional affiliations
October 2000 - December 2016
SDA Bocconi School of Management
Position
- Professor
January 2009 - present
October 2000 - present
Publications
Publications (90)
Project mandate
As part of its goals for quality development in the Swiss healthcare system between 2021 and 2024, the Federal Council has instructed the Federal Quality Commission (FQC) to develop a monitoring system and a dashboard for quality development and transparency. To this end, the FQC has mandated us as external research team to create a...
Health promotion and primary prevention are a priority in a healthcare system characterised by a prevalence of chronic conditions. In this context, motivational interviewing (MI) as provided by family doctors (FDs) seems promising: influential health professionals motivate patients to adopt healthy lifestyles in a patient-centred style that promote...
Objectives Previous research highlighted that in the early 2000s a significant share of the Italian population used and paid out of pocket for private healthcare services even when they could potentially have received the same treatments from the National Health Service (NHS). The decrease in public investments in healthcare and the increase in hea...
Background
Health economic evaluations of the implementation of evidence-based interventions (EBIs) into practice provide vital information but are rarely conducted. We evaluated the health economic impact associated with implementation and intervention of the INTERCARE model—an EBI to reduce hospitalisations of nursing home (NH) residents—compared...
Background:
Unplanned nursing home (NH) transfers are burdensome for residents and costly for health systems. Innovative nurse-led models of care focusing on improving in-house geriatric expertise are needed to decrease unplanned transfers. The aim was to test the clinical effectiveness of a comprehensive, contextually adapted geriatric nurse-led...
Die Schweiz erlebt wie die meisten Länder weltweit einen Wandel in der Erbringung von Gesundheitsdienstleistungen, der durch demografische, wirtschaftliche und technologische Trends angetrieben wird. Angesichts einer alternden Bevölkerung steigt die Zahl älterer Menschen, die Pflege benötigen. Gleichzeitig ist es schwierig, genügend Personal für di...
A follow-up study of our six-country study of 2010, this book analyzes the healthcare reforms of twelve small and medium-sized nations across the globe in the last three decades. It uses economic terms and political science vocabulary to describe and analyze the policy ambitions, plans and ultimate outcomes of the reforms and shows while there has...
Objectives
Reducing nursing home hospitalizations for ambulatory care sensitive conditions (ACSC) has been identified as an opportunity to improve patient well-being and reduce costs. The aim of this study was to identify number of hospitalizations for ACSCs for nursing home residents in a Swiss national sample, examine demographic characteristics...
Objectives:
Nursing home (NH) residents with complex care needs ask for attentive monitoring of changes and appropriate in-house decision making. However, access to geriatric expertise is often limited with a lack of geriatricians, general practitioners, and/or nurses with advanced clinical skills, leading to potentially avoidable hospitalizations...
Background
Increasing chronic conditions and multimorbidity is placing growing service pressures on health care, especially primary care services. This comes at a time when GP workforce shortages are starting to be felt across Switzerland, placing a threat on the sustainability of good access to primary care. By establishing multiprofessional teams...
Within the framework of a broader e-health strategy launched a decade ago, in 2015 Switzerland passed a new federal law on patients' electronic health records (EHR). The reform requires hospitals to adopt interoperable EHRs to facilitate data sharing and cooperation among healthcare providers, ultimately contributing to improvements in quality of c...
Physical or mental impairments, which affect NHS employees' ability to safely perform assigned work, are relevant issues in health policy. Moreover, the aging of NHS staff, the cost-containment policies in public spending and the limited fungibility of work tasks are increasing the inherent complexity of workforce management in healthcare sector. T...
This analysis of the Swiss health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The Swiss health system is highly complex, combining aspects of managed competition and corporatism (the integration of interest groups in the policy process) in...
The article describes a recent Swiss popular initiative, aiming to replace the current system of statutory health insurance run by 61 competing private insurers with a new system run by a single public insurer. Despite the rejection of the initiative by 62% of voters in late September 2014, the campaign and ballot results are interesting because th...
La valutazione delle competenze e delle
performance individuali dei medici è un
tema centrale del management degli ospedali.
Nonostante tale centralità, nella tradizione
italiana tale valutazione era implicitamente
lasciata al controllo sociale che si svolgeva tra
i medici, senza un esplicito coinvolgimento
del management (né quello di line delle u...
The performance and competences appraisal of physicians is a central theme of hospital management. Despite this importance, in the Italian tradition that assessment was implicitly left to the social control that took place between doctors, without explicit involvement of the management (neither of line management, nor of administrative technostruct...
User involvement is encouraged within the European Union (EU) within healthcare, most commonly in the form of patient choice. This has recently been further extended in relation to cross-border hospital care (1). The nature of user involvement, however, extends beyond the role of consumer choice to include that of the 'citizen' and of the 'co-produ...
The Italian National Health Service (INHS) has undergone profound changes over the past three decades. With establishment of the INHS in 1978--a tax-based public health care system with universal coverage--one of the underlying principles was integration. The recognition of health and health care as requiring integrated answers led to the creation...
It’s more than a decade that in Italy nurses have reached a full «university status». Yet, there seems still to be
a wide gap between nurses’ formal qualification and their actual role and status in healthcare organizations.
The article argues that a predictable physicians shortage, a growing attention to operations efficiency and the diffusion of...
It's more than a decade that in Italy nurses have reached a full «university status». Yet, there seems still to be a wide gap between nurses' formal qualification and their actual role and status in healthcare organizations. The article argues that a predictable physicians shortage, a growing attention to operations efficiency and the diffusion of...
The article describes the feminisation of the Italian medicine, addressing three questions: (1) What is the pace of feminisation among the Italian NHS doctors? (2) Is there any evidence of glass ceiling for them? (3) Which consequences we can expect from this feminisation? In 2007 women represented 35% of medical doctors employed by the Italian NHS...
For many years Italy has had more active physicians than most Western countries. However, the numerus clausus introduced in 1986 for entry into medical schools together with a sharp decrease in places available in specialty training have changed the situation dramatically and today several specialties suffer actual shortages. In such a situation, p...
An acceleration in the professionalization of Italian nurses has taken place in recent years. This pattern, together with the increasing prevalence of kidney diseases and the decreasing number of active nephrologists, makes a new collaborative structure between nurses and nephrologists both possible and welcome. This article describes the recent ch...
Equity in delivery and distribution of health care is an important determinant of health and a cornerstone in the long way to social justice. We performed a comparative analysis of the prevalence of Italian and British residents who have fully paid out-of-pocket for health services which they could have obtained free of charge or at a lower cost fr...
The article describes the feminisation of the Italian medicine, addressing three questions: (1) What is the pace of feminisation among the Italian NHS doctors? (2) Is there any evidence of glass ceiling for them? (3) Which consequences we can expect from this feminisation? In 2007 women represented 35% of medical doctors employed by the Italian NHS...
Private health insurance is increasingly popular in Italy. The articles examines an example of supplementary insurance plan issued by a non-profit organisation and distributed by a leading Italian large retailer. While not representative of the whole private health insurance supply available in the country, nevertheless the analysis allows us to lo...
Private health insurance is increasingly popular in Italy. The articles examines an example of supplementary insurance plan issued by a non-profit organisation and distributed by a leading Italian large retailer. While not representative of the whole private health insurance supply available in the country, nevertheless the analysis allows us to lo...
Absenteeism is a paramount issue in the Italian public debate run on newspapers and other mass media, but few – if any – contribution has been made in the healthcare management literature. The article describes an example of control system developed by an Italian public hospital trust. The system is aimed both to control absenteeism and to support...
A rich literature deals with health inequalities between different socioeconomic groups in terms of mortality
rates and other solid indicators, some of which are even worsening in many developed countries. Explanations range from differences in access conditions to healthcare services, to psycho-social determinants related to individual or collecti...
The paper describes the recent reforms affecting the institutional and managerial framework for
the Municipalities of Canton Ticino (Switzerland), and offers insights about their future. A focus is
provided on human resources management, also referring to a middle-size Municipality. The Ticino
context is characterized by a strong persistence of bur...
This study explores how Italian public hospitals can use private medical activities run by their employed physicians as a human resources management (HRM) tool. It is based on field research in two acute-care hospitals and a review of Italian literature and laws. The Italian National Health Service (NHS) allows employed physicians to run private, p...
Italy is an increasingly ageing society. This trend strongly affects the long-term care system, since new arrangements and new skills are requested to face this evolution. In the Italian context, home care to elderly people is increasingly often provided by immigrant caregivers, on the basis of a contractual agreement
between the family and the car...
This study builds a framework to investigate the current trends emerging in hospital organizational design and its main consequences on human resources management. The analysis derives from an extensive literature review, which shows over the last 30 years a significant lack of works on organization design for hospitals, and from a number of experi...
Healthcare managers often ask for staffi ng systems. In Italy, during the 90’s public healthcare organizations were required to develop and use staffing systems for all the personnel. Those efforts had poor – if any – results and a sense of disaffection and powerlessness is still alive. But some international experiences concerning particularly hos...
The human resource management (HRM) in the Italian health organisations is influenced by two main factors: the professional status of most of its employed staff, and the public employment regulation. The article discusses the first of those factors, with a focus on two dimensions: professional autonomy and the existence of the professions’ system....
The demographic profile of Italian nephrologists For many years Italy has had more active physicians than most Western countries. However, the numerus clausus introduced in 1986 for entry into me-dical schools together with a sharp decrease in places available in specialty training have changed the situation dramatically and today several specialti...
Nurses and nephrology in Italy An acceleration in the professionalization of Italian nurses has taken place in recent years. This pattern, together with the increasing prevalence of kidney diseases and the decreasing number of active nephrologists, makes a new col-laborative structure between nurses and nephrologists both possible and welco-me. Thi...
La tesi tratta del personale del Servizio Sanitario Nazionale italiano guardando agli aspetti di regolamentazione professionale e ai cambiamenti nella struttura e nella composizione degli organici. Tali cambiamenti sono poi indagati per le ripercussioni sulla gestione del personale e, più in generale, sulla funzionalità delle aziende sanitarie pubb...