Trade union or trait d'union? Setting targets for general practitioners: A regional case study.
AIMS
The Italian general practitioners (GPs) are not directly employed by the National Health Service but work as independent contractors. Their activity and their salary are managed at the national, regional, and local level. This paper analyses the Tuscany Region case study to investigate if primary care's target-setting styles are associated with different GP perceptions, by comparing nine different local agreements to a survey on 102 GPs. We propose a classification of the different target-setting (ideal typical) styles, ranging from "financial governance" (FG), mainly based on financial targets, to "clinical governance" (CG), that mainly relies on clinical and quality targets.


FINDINGS
Results show that GPs are more likely to have a more favourable attitude toward primary care managerial tools if they have certain characteristics, ie, quality measures. This suggest that target setting system might promote both the GPs' compliance to the targets set by the agreement and the involvement of the GPs in the LHA's governance processes too.


CONCLUSIONS
The managerial tools could pave the way to overcome the classical "trade unionist" relationship between the regional and local authority and the GPs, working as a "trait d'union" between the two players.
['Barsanti|Sara|S|https://orcid.org/0000-0001-7415-879X', 'Vola|Federico|F|', 'Bonciani|Manila|M|']
D001291:Attitude of Health Personnel D005260:Female D058005:General Practitioners D006801:Humans D007558:Italy D008297:Male D008875:Middle Aged D011320:Primary Health Care D058996:Quality Improvement D012041:Regional Medical Programs D012052:Reimbursement, Incentive
primary care clinical governance managerial tools integration