Measurement and predictors of the financial performance of public health enterprises in Italy

Introduction: In the healthcare sector, hospitals are by far the largest producers. As their costs continue to rise, sustaining long-term financial sustainability is becoming increasingly difficult. The measurement of healthcare providers’ financial performance is less developed in European countri...

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Main Authors: Peter PERGER, Achim HECKER
Format: Article
Language:English
Published: Edizioni FS 2023-12-01
Series:Journal of Health and Social Sciences
Subjects:
Online Access:https://journalhss.com/wp-content/uploads/JHSS_MSRM7.pdf
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author Peter PERGER
Achim HECKER
author_facet Peter PERGER
Achim HECKER
author_sort Peter PERGER
collection DOAJ
description Introduction: In the healthcare sector, hospitals are by far the largest producers. As their costs continue to rise, sustaining long-term financial sustainability is becoming increasingly difficult. The measurement of healthcare providers’ financial performance is less developed in European countries compared to others; structured information on financial performance is especially scarce when providers are publicly financed. Methods: This study constructs and validates a multidimensional financial performance measure (common factor approach) by the example of Public Health Enterprises (PHEs) in Italy, based on publicly available data. In a second step, several predictor variables are examined in a PLS-SEM model (partial least squares - structural equation model), including the environmental factor umbrella institutions' financial performance (Region), structural factors size (absolute), size class, teaching/scientific function and specialization, operational factor occupancy and complexity of treatment and the staffing factor non-medical staff rate. Results: The proposed measure aggregates multiple dimensions of financial performance (e.g. profitability, liquidity, capital structure) and satisfies all necessary conditions of construct reliability and validity. For PHEs in Italy, financial performance is significantly negatively influenced by the Region's financial performance (financial recovery plans) and the complexity of treatment, whereas medium-sized and specialized providers show comparatively significantly better performance levels. For the variables: size (absolute), teaching/scientific function, occupancy, and non-medical staff rate, no significant influence could be found. Discussion: This study provides insights into the financial performance of PHEs and is useful in identifying risks (negative influencing predictors and their trend) as well as favorable circumstances (positive influencing predictors and their trend). Moreover, different policymakers (the central government, the central bank, regions, and supervisory bodies, such as the court of auditors) may take an advantage from using this information and methodology to ensure the healthcare system is sustainable and adequately controlled in the long run. Our approach may also be useful for banks and credit institutions, or hospital pharmaceutical and medical device suppliers in estimating financial risks associated with their counterparty.
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spelling doaj-art-3f02f48fce1d4a40a0f09e41280a705c2025-01-18T18:20:29ZengEdizioni FSJournal of Health and Social Sciences2499-22402023-12-018433735610.19204/2023/MSRM7Measurement and predictors of the financial performance of public health enterprises in Italy Peter PERGERAchim HECKERIntroduction: In the healthcare sector, hospitals are by far the largest producers. As their costs continue to rise, sustaining long-term financial sustainability is becoming increasingly difficult. The measurement of healthcare providers’ financial performance is less developed in European countries compared to others; structured information on financial performance is especially scarce when providers are publicly financed. Methods: This study constructs and validates a multidimensional financial performance measure (common factor approach) by the example of Public Health Enterprises (PHEs) in Italy, based on publicly available data. In a second step, several predictor variables are examined in a PLS-SEM model (partial least squares - structural equation model), including the environmental factor umbrella institutions' financial performance (Region), structural factors size (absolute), size class, teaching/scientific function and specialization, operational factor occupancy and complexity of treatment and the staffing factor non-medical staff rate. Results: The proposed measure aggregates multiple dimensions of financial performance (e.g. profitability, liquidity, capital structure) and satisfies all necessary conditions of construct reliability and validity. For PHEs in Italy, financial performance is significantly negatively influenced by the Region's financial performance (financial recovery plans) and the complexity of treatment, whereas medium-sized and specialized providers show comparatively significantly better performance levels. For the variables: size (absolute), teaching/scientific function, occupancy, and non-medical staff rate, no significant influence could be found. Discussion: This study provides insights into the financial performance of PHEs and is useful in identifying risks (negative influencing predictors and their trend) as well as favorable circumstances (positive influencing predictors and their trend). Moreover, different policymakers (the central government, the central bank, regions, and supervisory bodies, such as the court of auditors) may take an advantage from using this information and methodology to ensure the healthcare system is sustainable and adequately controlled in the long run. Our approach may also be useful for banks and credit institutions, or hospital pharmaceutical and medical device suppliers in estimating financial risks associated with their counterparty.https://journalhss.com/wp-content/uploads/JHSS_MSRM7.pdffinancial performancehealthcare providerhospitalspls-sempublic health enterprises
spellingShingle Peter PERGER
Achim HECKER
Measurement and predictors of the financial performance of public health enterprises in Italy
Journal of Health and Social Sciences
financial performance
healthcare provider
hospitals
pls-sem
public health enterprises
title Measurement and predictors of the financial performance of public health enterprises in Italy
title_full Measurement and predictors of the financial performance of public health enterprises in Italy
title_fullStr Measurement and predictors of the financial performance of public health enterprises in Italy
title_full_unstemmed Measurement and predictors of the financial performance of public health enterprises in Italy
title_short Measurement and predictors of the financial performance of public health enterprises in Italy
title_sort measurement and predictors of the financial performance of public health enterprises in italy
topic financial performance
healthcare provider
hospitals
pls-sem
public health enterprises
url https://journalhss.com/wp-content/uploads/JHSS_MSRM7.pdf
work_keys_str_mv AT peterperger measurementandpredictorsofthefinancialperformanceofpublichealthenterprisesinitaly
AT achimhecker measurementandpredictorsofthefinancialperformanceofpublichealthenterprisesinitaly