title: Efficiency as a domain of health care systems: a phenomenographic approach.
abstract: OBJECTIVE
  This paper focuses on efficiency as a central theme of the Italian health care reforms, combining macrolevel policies with microlevel (i.e., operating room) perceptions of the concept.
  
  
  METHODS
  According to the phenomenographic approach, this analysis investigates how the components of a surgical team (22 semistructured interviews) experience efficiency in their daily workflows.
  
  
  RESULTS
  The main findings show that the concept of efficiency is multidimensional. According to participants' perspective, several categories of efficiency collected in an outcome space emphasize an holistic view of efficiency driving health policies and strategies.
  
  
  CONCLUSIONS
  The suggestion of further relationships between perspectives and other constructs (i.e., quality, safety, patient focus, process) at micro and macro level could enhance the impact of health reforms.
  
  
  CONCLUSIONS
  A qualitative approach conducted at microlevel help to recognize the phenomenon (of efficiency), engaging the individual conception that practitioners have of the health efficiency.
authors.affiliation: Department of Management, Economics and Quantitative Methods, University of Bergamo, Bergamo, Italy.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Cattaneo
authors.forename: Giovanna
authors.initials: G
authors.lastname: Galizzi
authors.forename: Gaia
authors.initials: G
authors.lastname: Bassani
mesh_terms: D017598:Efficiency, Organizational; D018166:Health Care Reform / Q000458:organization & administration*; D006298:Health Services Administration; D006302:Health Services Research; D006801:Humans; D007558:Italy; D010348:Patient Care Team / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration; D024382:Professional Role; D011787:Quality of Health Care / Q000458:organization & administration; D012107:Research Design