The current world challenges include issues such as infectious disease pandemics, environmental health risks, food safety, and crime prevention. Through this article, a special emphasis is given to one of the main challenges in the healthcare sector during the COVID-19 pandemic, the cyber risk. Since the beginning of the Covid-19 pandemic, the World Health Organization has detected a dramatic increase in the number of cyber-attacks. For instance, in Italy the COVID-19 emergency has heavily affected cybersecurity; from January to April 2020, the total of attacks, accidents, and violations of privacy to the detriment of companies and individuals has doubled. Using a systematic and rigorous approach, this paper aims to analyze the literature on the cyber risk in the healthcare sector to understand the real knowledge on this topic. The findings highlight the poor attention of the scientific community on this topic, except in the United States. The literature lacks research contributions to support cyber risk management in subject areas such as Business, Management and Accounting; Social Science; and Mathematics. This research outlines the need to empirically investigate the cyber risk, giving a practical solution to health facilities.

Civil liability represents one of the main responsibilities for healthcare facilities; it is the legal responsibility of paying money for damage to a person’s health. Even though this responsibility plays a key role in the economic sustainability of healthcare facilities, the literature does not enough investigate this responsibility in regional health services. The paper aims to define the evolution of compensation models for health civil liability adopted by regional health services. Through a longitudinal case study, the paper investigates the compensation model by a leading regional health service. The finding highlights the evolution of the compensation model for health civil liability adopted by a leading Regional Health Service from 1990 to 2021. It describes a transition from an insurance model to a mixed model based on self-coverage up to a set economic level, an insurance policy with self-insurance retention and deductible for all claims. The research contributes to the literature and practice throughout the definition of a compensation model for damages based on self-insurance of regional health service and insurance policies. The research promotes a compensation model used by a leading regional health service.

The increase in claims for compensation by patients to public healthcare companies highlights the key role of the provision for risks and charges. The resources set aside in the provision for risks determine the ability to cover losses or debts of determined nature, of certain or probable existence, of which, however, either the amount or the date of occurrence is undetermined. The research aims to identify the evolutionary trend of the provision of risk in national public healthcare companies. Moreover, it forecasts the future trend of provision for risks divided per the protection of civil liability towards third parties model. The research adopts a quantitative methodology to facilitate replicability and to investigate the trend of the provision for risks of a national public healthcare context, i.e., Italian public healthcare context. The research data set includes accounting information collected by websites of healthcare facilities in order to comprehend the evolutionary trend of the provision for risks. The results of the research describe a stable trend in the resources set aside in the provision for risks, a continuous decrease in the use of the provision for risks with a consequent increase in the fund itself, and a discontinuous trend in the percentage ratio between the annual provisions for the risk and the fund itself.

The Directive 2014/23/EU established the principle of free administration by national, regional and local authorities in conformity with national and the European Union law. According to the principle, the authorities can decide how to manage the works or services to ensure a high level of quality, safety, affordability, equal opportunity access and user rights. This principle allows an in-house award of concession contracts that requires an economic assessment of the adequacy of the offer and the benefits of the chosen management for the community. Given the complexity of the assessment, the scientific literature requires an address to define economic fairness and the benefits of the chosen management for the community. The paper aims to define an approach useful for establishing the economic congruity and community benefits for direct awards to in-house companies. This paper conducts a systematic legislation review of a European country, Italy. This research reviews the main Italian legislation following the systematic review proposed by Tranfield et al. (2003), which is one of the most recognized, tested and validated methods for literature review used in scientific studies. The results highlight an integrated approach for establishing and reporting the economic adequacy and benefits of the chosen management as well as for comparing the pricing and benefits of the works or services directly awarded. The study gives a practical contribution to public authorities developing a guideline useful for an integrated assessment of the economic congruity and community benefits for direct awards to in-house companies; furthermore, this study supports the scientific literature through a framework that summarizes the main legislation.