Organizational capabilities in health care institutions: a multisource territorial study

Abstract

The Italian debate on territorial healthcare is currently focused on the implementation of various measures under the National Recovery and Resilience Plan (PNRR), particularly Mission 6 on Health, aimed at enhancing human resources and services. This paper examines, from an ex-ante perspective, the potential capability of regional health institutions using an input-output framework applied to personnel classified by socio-demographic characteristics. The analysis draws on two key official data sources: the Annual Accounts from the Ministry of Economy and Finance, and ISTAT Multipurpose Household Survey. A comparison is made between the most recent available data (2022) and that from 2012. The authors introduce a novel composite index of organizational functionality (IFO-Health), which aggregates 10 distinct, minimally correlated, indicators related to the quality of human capital. The findings reveal a persistent disparity in responsiveness of territorial healthcare, particularly in southern regions of Italy, where weaknesses in human capital are relevant. These areas often correspond with regions under Health Deficit Recovery Plans and report lower levels of patient satisfaction with medical and nursing care.