The healthcare reform, introduced in Italy in 1992, has completely changed the structure of the national healthcare system (NHS) , including the introduction of the concept of "business firm" applied to public health service providers. The aim of this study was to outline the history of healthcare "firms" (azienda sanitaria) and evaluate the impact of this change on the NHS in terms of health expenditure, and corporate effectiveness and efficiency. Self regulation and correction are the abilities to which the success of healthcare companies can be attributed. The benefits of creating healthcare firms include preventing those problems associated with healthcare models based on the principles of the private insurance type model and preferring instead a cost-effectiveness approach.
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