Logistics Reorganisation in Regional Healthcare Service Experience From Italian Perspective: The Case of Tuscany

The increasing pressure on public expenditure in Italy and in healthcare sector is creating two important phenomena: first, the progressive regionalization of healthcare systems; and second, the search for new organizational models aiming to public expenditure rationalizing and higher levels of efficiency. The regionalization is changing the administrative and organizational structure of the State in a federal way by identifying distinctive characteristics that are reflected in the organization of the Italian healthcare system. The second phenomenon, however, is leading to different regional administrative models, which tend to compete. In Italy, logistics centralization seems more appropriate to improve the efficiency and to decrease public expenditure of healthcare system. Concerning the reorganization in healthcare service, Tuscany region’s goal is to become a benchmark to many other regional systems. This study analyzes the first three years’ implementation of logistics reorganization through the evolution of PBP (Percentage of Brokering in Purchasing) ratio and stock variations, in order to measure the performance in the Tuscany healthcare service. This research emphasizes contrasting issues: Tuscany healthcare service shows a significant reduction in the number of warehouses; at the same time the decision to logistics centralization has produced a substantial increase in regional warehouses. We argue that the centralization of logistics in Tuscany healthcare service will produce the desired effect only in the medium-long term, instead we can observe problems of short-term management in logistics centralization.