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f e c h a d e r e c e p c i ó n : 0 9 / 1 0 / 2 0 1 0 f e c h a d e a c e p t a c i ó n : 1 5 / 1 2 / 2 0 1 0 ResumenEntender las razones del fracaso o el éxito de las reformas impulsada por el NPFM es un tema que ha atraído recientemente la atención de la literatura sobre la gestión del sector público. Sobre la base de un estudio de caso realizado en el gobierno local italiano, la investigación analiza el estado de real aplicación de las reformas mencionadas anteriormente, y contribuye al debate teórico sobre las razones que explican las diferencias entre los cambios formales y sustanciales en la administración utilizando un enfoque institucional. Para este fin se realizó una encuesta sobre una muestra estadísticamente representativa de los municipios italianos con más de 5.000 habitantes y una serie de entrevistas semi-estructuradas con observadores privilegiados. Basándose en los resultados del análisis, la introducción de reformas inspiradas en el NPFM en Italia se puede considerar como un caso en el que la innovación anunciada por la ley es más formal que de fondo. En cuanto a las razones de la brecha entre los cambios administrativos de forma y de fondo, los resultados del estudio sugieren la hipótesis de una correlación directa entre las prácticas contables y, respectivamente, las presiones isomorfas que han acompañado a la 1 School of Economics, Viale S. Ignazio 17, 09123-Cagliari, Italy.The paper is the result of a joint effort of the three authors. In particular, Elisabetta Reginato wrote the Section 2, 4, 5.2 and 6; Isabella Fadda wrote the Section 3 and 5.1; Aldo Pavan wrote the Section 1. The authors wish to acknowledge Claudio Conversano for his precious help with the statistical analysis. AbstractUnderstanding the reasons for the failure or the success of NPFM reforms is an issue that has recently attracted the attention of public sector management literature. Basing on the Italian Local Government −LG− case, the research analyses the NPFM reform actual implementation, and contributes to the theoretical debate about the reasons for the discrepancies between actual and formal accounting changes using an institutional approach.To this end a survey carried out on a statistically representative random sample of Italian municipalities with more than 5,000 inhabitants together with semi-structured interviews to privileged observers are used. According to the results of the analysis, the Italian NPFM reforms introduction can be regarded as a case wherein innovation heralded by the law is rather formal than substantial. As regards the reasons for the gap between formal and actual changes the study findings suggest the hypotheses of a direct correlation between accounting practices and respectively isomorphic pressures affecting the introduction of the new accounting tools −New institutional sociology (NIS)−, municipality's organisational culture −Old institutional economics (OIE)− and municipalities' size.

Understanding the reasons for the failure or the success of reforms is an issue that has recently attracted the attention of many scholars in the public sector field. The present study tries to contribute to this debate focusing on the social and cultural environment of the communities wherein the reforms are introduced as well as on their structural characteristics. The research is based on a survey carried out on a representative sample of Italian municipalities, whose aim is to understand the state of accomplishment of the Italian local government financial management reform. To this end, a set of internal control tools and techniques is analysed to assess whether they have been adopted and how they have been used. The findings of this part of the study are then related to the size of the entities -used as a proxy for the organizations visibility and complexity -as well as to their geographic location -used as a proxy of their socioeconomic environment. Results show that both the social and structural characteristics have influenced the reform accomplishment.

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The paper explores the relationship between corruption and performance dimensions of the Italian regional health care systems (RHSs). In Europe, Italy shows the widest sub-national in performance and corruption levels. The research focuses on petty corruption in health care. So-called informal payments are the most common form and were measured using data from the European Quality of Government Index Survey. The performance of Italian RHSs was assessed using key indicators divided into three analytical dimensions: health status; access to care; and quality of care. OECD Health Data was used as source data for health status and access to care. As a proxy for quality of care, the study used avoidable mortality, with data drawn from the Italian National Institute of Statistics (ISTAT). The study formulated a research hypothesises that petty corruption has a negative influence on RHS performance. The findings showed considerable regional differences. The results did not confirm the research hypotheses. However, informal payments did show an adverse effect on renunciations to specialist medical examinations due to costs.