Martedì 17 dicembre 2025, ore 10.00 – 12.00 • Fondazione Marco Biagi
Market Structure and Quality Efficiency in Emilia-Romagna’s Mixed-Provider Care Home Sector
Relatore
EDOARDO PIOMBINI, Student XXXIX, Fondazione Marco Biagi – Unimore
Discussant
GAETANO FRANCESCO COPPETTA, Postdoc. Fellow, Department of Management, Economics, and Industrial Engineering, Politecnico di Milano
Chair
FILIPPO SIMEONE, Student XXXIX, Fondazione Marco Biagi – Unimore
Abstract
We provide novel empirical evidence on the structure and dynamics of the care home market in the Emilia Romagna region (Italy), differentiating between services for self-sufficient and non-self-sufficient residents. Leveraging newly available administrative data, we initiate an interdisciplinary research agenda for the Italian care home sector though the lens of industrial organization. Specifically, we examine how service specialisation and multi-plant operational strategies among providers shape market concentration, technical efficiency, and productivity within localised sub-markets of the region. Preliminary findings show that the provision of specialised care services and multi-facility provider structures significantly increase market concentration at both regional and sub-regional levels. This finding raise questions about competitive behaviours, allocative efficiency, and equitable access in a mixed-provision system where public, not-for-profit and for-profit providers each hold roughly one-third of the market share – albeit with substantial sub-market variation. Drawing on administrative data covering all 1,227 active facilities (34,622 beds), we first document market concentration patterns using the Herfindahl-Hirschman Index, distinguishing between services for self-sufficient and non-self-sufficient residents, and accounting for multi-plant provider structures. We find that aggregate balanced market shares across public, not-for-profit, and for-profit providers mask substantial sub-market concentration, particularly when chain ownership is considered and public providers are excluded from the analysis.
We then develop an application of Stochastic Frontier Analysis to assess technical quality efficiency, defining avoidable emergency department visits (dismiss or white and green triage codes) as the “bad output” to be minimized given staffing inputs. Using cross-sectional data from care homes in Modena province, we estimate production frontiers where inefficiency represents excess adverse events attributable to managerial factors. Key findings indicate that care assistant (OSS) staffing is significantly protective, with a 10\% increase associated with 10–16% fewer avoidable ED visits. Facility size exhibits diseconomies of scale in quality production, while ownership type shows no statistically significant effect on quality efficiency—suggesting that regional accreditation standards may effectively homogenize care practices across provider types. Mean inefficiency estimates of approximately 50% highlight substantial scope for quality improvement. We discuss extensions to Spatial Stochastic Frontier models to capture geographic spillovers and territorial dependencies in future research.
From Local Ties to Strategic Advantage: Leveraging Rootedness for Environmental Initiatives
Relatore
FRANCESCO CHIRICO, Student XXXIX, Fondazione Marco Biagi – Unimore
Discussant
CECILIA CORREGGI, Postdoctoral fellow, Department of Economics Marco Biagi, University of Modena
Chair
FILIPPO SIMEONE, Student XXXIX, Fondazione Marco Biagi – Unimore
Abstract
This study highlights territorial rootedness as a strategic resource and source of differentiation for firms environmental initiatives. While its potential is recognized, we know little about the processes through which it shapes organizational adaptation and firm’s strategy. We examine whether high- and low-rooted firms prioritize different environmental initiatives, and how rootedness interact with social and economic pressures, also assessing its association with innovation moderated by the same pressures. The conceptual framework integrates embeddedness with the micro-foundations of dynamic capabilities where rootedness tailors seizing strategies and subsequent reconfiguration processes, generating a locally grounded organizational model. Using a novel database gathering firms microdata with local data across 145 EU regions, we find distinct priorities in environmental initiatives, and that, in regions with high-rooted firms, innovation is higher under economic pressures than social pressure. For managers, leveraging rootedness enables context-specific environmental initiatives balancing short-term legitimacy with long-term strategic benefits, converting local ties in competitive advantage.
Keywords: Territorial Rootedness, Organizational dynamic capabilities, Environmental Initiatives, Innovation, European Regions, Strategic Differentiation.
Il seminario si terrà in lingua italiana e la partecipazione è libera.
Ulteriori informazioni: +390592056092 | phd_lavorosviluppoinnovazione@unimore.it