Planning and Managing of Diagnostic Imaging Technologies in Healthcare: The Introduction of Managed Equipment Service (MES) for the System’s Sustainability

The lack of resources has driven healthcare management studies to recognise Private and Public Partnerships (PPP) as the solution in managing efficiency, effectiveness and profitability of technological innovation. Recent researchers have identified the buying model called Managed Equipment Service (MES), in which purchaser and seller share the risks of technology’s management and use, as an optimal problem-solving method. The aim of this research is to analyse the potential economic-financial and organizational benefits of MES introduction in healthcare, in particular for the acquisition of the diagnostic imaging technologies. The research applies the case study method. We have examined a representative Italian Local Health Authority for its dimensions, managerial characteristics and case-mix offered but, especially, for its high health standards. In the study we have involved the strategic figure of radiographer in diagnostic imaging. The data has been elaborated through statistical analysis to observe the correlations. Evidence demonstrates that MES costs are lower than all the other planning and purchasing methods analysed (between 11% - 239%). When correlations between age of facilities and effectiveness of provided services is strong, MES grants the maintenance of a lower average age of technologies and a more efficient use of resources and significant margins of profitability. The emerging model of PPP is a possible solution to the current issues surrounding economic and financial sustainability of healthcare systems, considered the fewer resources and the technological progress. MES in healthcare appears to be a highly efficient way of managing innovation, in particular for diagnostic imaging technologies. Keywords: Public Private Partnership (PPP), Managed Equipment Service (MES), middle-high technologies, diagnostic imaging

A collaborative approach in tourism planning: The case of Tuscany region

Community collaboration and participation are necessary to strengthen the effectiveness of tourism policy. This article aims to examine the tourism planning activity of public administration in fostering a collaborative approach. The article contributes to the debate on collaborative approach in tourism from the perspective of public administration. The research uses a case study and examines how Tuscany region applies a collaborative tourism planning approach using the Habermasian framework. Results underline the fundamental role of local government can be strengthened by an extensive stakeholder engagement process able to encourage broad representation and trust of stakeholder interest about public policies. Moreover, the collaborative approach by mixing the different point of view of stakeholders, produces a range of positive outcomes and increases the efficacy of tourism policies. However, the realization of the "ideal speech situation" is very difficult and may be undermined by the threatens highlighted in the study, such as the lack of financial resources, the claim to more homogeneous policies to increase tourism trends, the need to improve trust and collaboration between public and private, the difficulties in maintaining high level of attention and the widespread scepticism about the capability of public entities to understand priorities in defining tourism policies