Il ruolo delle Aziende Sanitarie Locali nella gestione della spesa ospedaliera alla luce di un’indagine empirica sulla ASL di Como

[Machine translation] The present work, through the analysis of the methods, Financing ASL hospital admissions, of Como, it is proposed to verify the implementation of, Lombard model wanted by law 31/1997. Tale, The model is based on the separation of competencies, between the Region (funding), ASL (bargaining and, programming) and dispensing entities (production)., The failure to transfer programming powers to, ASL, as demonstrated by the case studied, has brought,, In the years considered, with increasing deficits, on the part of hospitals, countered with measures, temporary low incidence. The conclusions, suggest that, in order to keep under control, hospital expenditure, it is necessary for local health authorities to define, ex ante and with each provider, volumes,, type and criteria for financing admissions. La, The credibility of the system depends on a consistent basis, from the lack of planatory interference, on the part of the Region.