Evaluating the quality and effectiveness of regional healthcare systems: A non-parametric analysis of ISTAT health for all data

Filippo Elba, Cristiano Ciappei, Riccardo Rialti, Lamberto Zollo


Purpose. The aim of this paper is to evaluate the effectiveness and efficiency of the Health Services (RHSs) in Italy. Based on the Istat’s Health for All (IHFA) data, this study assesses Italian Hospital Services (HSs) and Health Assistance Services (HASs) between 2010 and 2013, considering both quantitative and qualitative aspects.

Methodology. The Multiplicative Non-Parametric Corporate Performance (MNCP) model by Emrouznejad and Cabanda (2010), namely the Data Envelopment Analysis (DEA). The assessment of effectiveness and efficiency of RHSs goes through three different steps. At first, we evaluate efficacy of regional HSs, integrating quantitative and qualitative analysis. Next, quality and efficacy of HASs have been evaluated. Finally, starting from the results obtained in the first two steps, the efficiency of RHSs in producing their quali-quantitative level of services has been assessed.

Practical implications. This research provides evidences of the potential of DEA to evaluate the quality and effectiveness of healthcare service.

Originality/value. In most of the existing literature, the evaluation of RHSs focuses on efficiency of health services supply, assessed by quantitative variables. This means not only that qualitative aspects are ignored, but also that efficacy is overlooked. The main aim of this kind of studies is to minimize RHSs cost, even if this choice implies low level of services provided, in terms of number and quality of benefits. This paper aims to fill in this gap, the aforementioned methodology.


Healthcare management; service quality; public management; non-parametric analysis; data envelopment analysis

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