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This paper adds to literature on financial audit in public sector organizations. The authors examined the effect of adapting a private sector audit body—the Board of Statutory Auditors (BoSA)—for use by Italian public healthcare organizations. The research objective was to explore whether the characteristics generally required of private sector audit bodies (independence, accounting and financial expertise, industry specialization, diligence, and institutional support) are relevant to the public sector. Information on these characteristics was collected through an online questionnaire and used to explain audit quality. The results show the relevance of accounting and financial expertise, as well as industry specialization. The authors call for further research on the need for auditor independence in a public service setting.

This study contributes to the debate about control systems in the public sector by analyzing the characteristics and the activities of the Boards of Statutory Auditors in the Italian National Health Service. Extant literature has long emphasized the characteristics that auditing bodies are expected to possess in order to ensure audit quality. This paper offers an operationalization of such characteristics and discusses their peculiarities in a public-sector context. The relevant information was collected through an online questionnaire administered to the Boards of Statutory Auditors of all Italian public health-care organizations. The results show that the Boards’ characteristics are consistent with the literature’s suggestions and with the peculiarities of a public-sector setting. However, findings also underline some weaknesses in terms of both the adequacy of available resources and the relationship with other monitoring bodies and mechanisms.

The aim of this study was to evaluate the operations performed for pancreatic cancer nationwide in Italy during the period 2010–2012. A possible variability of treatment depending on the hospital volume was investigated, since the volume–outcome relationship in pancreatic surgery is well established. An estimate of the clinical and economic consequences of potentially incorrect surgery was performed.