Procurement and service management models in laboratory medicine: Reflections on organizational and managerial competencies supporting different approaches

The study investigates the prevailing service models within the context of laboratory medicine in Italy, concentrating on governance mechanisms that either facilitate or impede the choice between internalization and outsourcing of services.
The primary objective is to identify the managerial competencies required for commissioning and clinical governance, enabling public healthcare organizations to assess the most suitable service model according to their intrinsic characteristics.
To meet these objectives, three exploratory cases, representing the dominant service models, were selected.
Semi-structured interviews were conducted, focusing on key activity areas throughout the “life cycle” of supply contracts: (i) the tendering process, (ii) order management, (iii) equipment maintenance, and (iv) supplier performance evaluation. Furthermore, the authors’ managerial focus extended to understanding the cultural influences of different service models and the consequent implications for managerial decision-making. The conclusions underscore the strategic importance of selecting a service model that aligns with organizational needs and competencies, considering internal managerial skills (planning and monitoring capabilities), service volumes, and case mix.

Keywords: service models;quasi-market;Laboratorory Medicine;Value-Based Health;outsourcing;procurement

Elena Maggioni, Francesca Ferrè, I modelli di acquisto e gestione dei servizi nella Medicina di Laboratorio: riflessioni su competenze organizzative e gestionali in "MECOSAN" 134/2025, pp 53-76, DOI: 10.3280/mesa2025-134oa22002