The recent economic and financial crisis revealed the weaknesses of the Italian National Health Service, threatening its long-term sustainability. In an attempt to properly deal with the evolving attributes of their external environment, Italian regions affected by greater debt exposition and undergoing a rebalancing procedure have to implement radical policy and managerial interventions in order to rationalize their health expenditure. Ultimately, these interventions should aim at restoring the economic and financial equilibria of public health care organizations. In light of its relevant role in the health care budget, human resource management expenditure has drawn an increasing attention at both the policy and the management levels. This paper aims at investigating the consequences of the policies intended to rationalize human resource expenditures, focusing the attention on an Italian regional health system undergoing a rebalancing procedure. Sticking to the evidence collected from an engaged research, the manuscript describes the interventions implemented and tries to determine the effects of spending review initiatives on the financial and economic equilibria of health care organizations. The research findings point out that rationalization policies are effective in halting the economic and financial deficit of health care organizations. However, they should be supported by tailored initiatives at the organizational and the managerial levels, in order to minimize negative drawbacks on human resources’ motivation and commitment.
Keywords: Rationalization, Rebalancing, Sustainability, Deficit, Contractual funds.