Roberto Ippoliti

Efficiency of the medical care industry: Evidence from the Italian regional system

What might be the relation between clinical research and efficiency of medical care suppliers? Is the hypothesis of a positive relation consistent? Considering efficiency as the supplier’s ability to maximize the number of patients hospitalized in a mobility process among regions (i.e. mobility balance), this work aims at highlighting the existence of a positive externality of pharmaceutical clinical research on that kind of efficiency. In other words, an externality is able to affect the patients’ perception of good/bad quality of outputs supplied by the medical care industry, leading their mobility process. Taking Italy and the mobility of patients among regions into account, an Operational Research study will be performed in order to support this assumption.

Artificial Neural Networks and risk stratification models in Emergency Departments: The policy maker's perspective.

The primary goal of Emergency Department (ED) physicians is to discriminate between individuals at low risk, who can be safely discharged, and patients at high risk, who require prompt hospitalization. The problem of correctly classifying patients is an issue involving not only clinical but also managerial aspects, since reducing the rate of admission of patients to EDs could dramatically cut costs. Nevertheless, a trade-off might arise due to the need to find a balance between economic interests and the health conditions of patients. This work considers patients in EDs after a syncope event and presents a comparative analysis between two models: a multivariate logistic regression model, as proposed by the scientific community to stratify the expected risk of severe outcomes in the short and long run, and Artificial Neural Networks (ANNs), an innovative model. The analysis highlights differences in correct classification of severe outcomes at 10 days (98.30% vs. 94.07%) and 1 year (97.67% vs. 96.40%), pointing to the superiority of Neural Networks. According to the results, there is also a significant superiority of ANNs in terms of false negatives both at 10 days (3.70% vs. 5.93%) and at 1 year (2.33% vs. 10.07%). However, considering the false positives, the adoption of ANNs would cause an increase in hospital costs, highlighting the potential trade-off which policy makers might face.

Judicial Efficiency and Immigrant Entrepreneurs

Extensive research exists on the individual determinants of being an immigrant entrepreneur, concerning both social environment and human capital. However, the role of the judiciary has not been investigated yet. Analyzing more than 160,000 new micro enterprises owned by immigrants, our paper aims to fill this gap by focusing on the relation between justice and immigrant entrepreneurship. Results show that judicial efficiency is one of the determinants of self‐employment, although some differences among immigrant groups are identified. Therefore, the study confirms the key role of judicial enforcement in promoting not only growth but also the integration of these new citizens.

L’efficienza dei sistemi sanitari regionali in Italia: pubblico o privato?

The paper sets out to analyze the efficiency of regional health care systems based on the patients’ perception of the quality of the services provided. For the purpose of this study, efficiency is measured as interregional mobility, i.e., the number of a region’s residents that use the services of the regional health care system (positive mobility) and the number of non-regional patients that travel specifically to the host region to benefit from its medical care (negative mobility). Given the widespread take-up of social networks, the study assumes that people are willing to travel to areas where the quality of medical care is perceived to be higher. The first step was to perform a data envelopment analysis to obtain the efficiency scores. The second step consisted of conducting a regression analysis to respond to the paper’s main research question: to what extent might the public sector play a role in the efficiency of regional health care systems? The empirical evidence suggests that the privatization process of regional health care systems has failed to raise the efficiency of these particular suppliers in terms of the patients’ perception of the quality of their medical treatments.