We show that the introduction of the procurement centralization within the regional healthcare systems in Italy reduced per capita health expenditure approximatelyt by 2–8%, without affecting the level of health-related public services. Our results also indicate that the effect is persistent after six years, and is not influenced by the coexistence of other organizational models, such as amalgamation and hybrid systems. Finally, we document that the reduction in public expenditure is effective only in areas characterized by poor quality of institutions, indicating that procurement centralization might be an effective tool to reduce corruption-related inefficiencies in the health sector.

我们表明，在意大利的区域医疗保健系统中引入采购集中化措施，在不影响与医疗相关的公共服务水平的情况下，将人均医疗支出减少了大约2–8％。我们的结果还表明，这种影响在六年后仍然持续存在，并且不受其他组织模型（例如合并和混合系统）的共存影响。最后，我们记录到减少公共支出仅在机构质量低劣的地区才有效，这表明集中采购可能是减少卫生部门与腐败相关的低效率的有效工具。