Italian Regional Healthcare Services Put to the Test by Covid-19: Strategic and Managerial Issues from the First Wave

The Italian Regional Healthcare Services (RHSs) have the responsibility for the provision of health services in their territory, for the organizational design and strategic direction of public providers, and for contracts with private accredited providers. RHSs have had to rapidly adapt their strategies for the purpose of facing the Covid-19 health crisis. There is scarcity of research on the influence of RHSs over the organisational capacity and managerial autonomy of the healthcare organizations (HCOs) in responding to an emergency. This paper aims to investigate the role of the Italian RHSs in the governance of Covid-19 emergency and to
analyse the influence on the response of HCOs in managing the first wave. Findings show the prevalence of two models (centralized vs decentralized) in pandemic crisis management that have achieved different outcomes in the RHSs; oftentimes the weakness of regional strategies was compensated for by bottom up initiatives from individual HCOs.