Does corruption and the institutional characteristics of the contracting authorities affect the execution of healthcare infrastructures? An empirical investigation for Italy.

This paper investigates empirically whether the institutional features of the contracting authority as well as socio-economic variables (including the level of ‘environmental’ corruption) in the area where the work is localised affect the efficient execution of public contracts for healthcare infrastructures. To this purpose, a two-stage Data Envelopment Analysis (DEA) is carried out based on a sample of Italian public contracts for healthcare infrastructures during the period 2000-2005. First, a smoothed bootstrapped DEA is used to assess the relative efficiency in the implementetion of each single infrastructure contract. Second, the determinants of the efficiency scores variability are considered, paying special attention to the effect exerted by ‘environmental’ corruption on different types of contracting authorities. The results show that the performance of the contracts for healthcare infrastructures is significantly affected by ‘environmental’ corruption. Furthermore, healthcare contracting authorities are less efficient and more at risk of ‘environmental’ corruption than other public procurers