Abstract Chapter 12

In recent years, the Italian National Health Service has faced budget constraints and the shortage of professionals. Hence, the research has investigated the public employees’ demographics in the different Italian regional health services from 2010 to 2016, focusing on nurses and physicians. Moreover, an exploratory analysis was carried out to capture public healthcare organizations' emerging strategies to face recruitment constraints, focusing on the use of skill mix approach. The research shows substantial stability over time regional level of the nurse-to-physician ratio. No evidence of significant policies aimed at modifying the inertia in each regional healthcare systems has been found, despite population’s changing needs and cost control’ issues. Moreover, there isn’t any convergence of the nurse-to-physician ratios, among Italian regional health services. Finally, several critical issues regarding human resources management emerged, such as the increasing difficulties of finding physicians on the job market, regulatory rigidities limiting flexible working policies, the partial effectiveness of the current nurses’ selection process and the lack of levers able to restrain skilled nursing staff. Hence public healthcare organizations would benefit the adoption of constraints regarding not only staff's quantity but also staff's composition. Finally, it would be helpful the promotion of organizational models that allow all employees to exploit skills and abilities.