Outsourcing in the Italian NHS: A Measure of Mismatch Between Private and Public Operators


  • Paolo Mariani
  • Rosa Falotico
  • Biancamaria Zavanella
  • Mauro Mussini




Outsourcing, Pharmaceutical Industry, Mismatch Index, Healthcare Operators Satisfaction


Outsourcing is a useful tool for improving partnership between private and public companies. The budgetary constraints recently imposed by the Italian government on health industry are enhancing the urgency to outsource to face costs.

Our study deals with the relationship between ASLs (Aziende Sanitarie Locali, the Italian local health authorities) and private operators outsourcing in Italy. In particular we hypothesize that the level of matching between public demand and private supply of outsourcing can affect the outsourcing development in Italian National Health Service. Under this hypothesis we present an analysis that aims at quantifying the level of mismatch between pharmaceutical companies offer and ASL needs in order to understand the future developments of outsourcing.

We studied 44 pharmaceutical companies (with a yearly turnover of about € 6 billion) and 34 ASLs (with about 12 million users) to find out the areas in which they used outsourcing, the amount and the frequency of such investment, their satisfaction and their future intentions. We analysed the answers in search for possible relationships between location, size, frequency of use and other features to uncover a possible convergence between public and private interests in outsourcing.

To quantify the convergence for each area we used a mismatch index to measure the discrepancy between public and private operators. The results suggest that public and private outsourcing have a low mismatch which seems increasing in the future.

Author Biographies

Paolo Mariani

University of Milan-Bicocca

Rosa Falotico

University of Milan-Bicocca

Biancamaria Zavanella

University of Milan-Bicocca

Mauro Mussini

University of Verona




How to Cite

Mariani, P., Falotico, R., Zavanella, B., & Mussini, M. (2014). Outsourcing in the Italian NHS: A Measure of Mismatch Between Private and Public Operators. Symphonya. Emerging Issues in Management, (1), 66–80. https://doi.org/10.4468/2014.1.05mariani.falotico.zavanella.mussini