Exploring regionalism in public management reforms: the case of the Italian hospital sector

Abstract

Although comparative research on new public management reforms has identified variable pathways of change between countries, less is known about variations within countries where there has been significant political and administrative decentralisation to regional tiers of government. In this paper we address this concern, focusing on public hospital management reforms in the Italian Servizio Sanitario Nazionale (SSN) as an illustrative case. Drawing on a range of publicly available administrative data sources we find that there is a significant regional dimension, with more autonomous regional governments with centre-right political majorities being more likely to adopt corporate-style management practices at hospital level.