Integration in welfare policies, like the management of the processes of change in our welfare system are often dealt with and analysed from the perspective of the policy maker. In our country this is a response to a deficit in implementing and evaluating public policy and, still more, to the need for a more pragmatic approach to reform in the various areas of state intervention. This perspective becomes indispensable in the health sector, in particular, where the eternal debate on the public-private relation, on the costs of the national health service, or on the inadequacy of our services in relation to continually evolving health needs and demand, almost inevitably lead to large-scale questioning of the reforms carried out, starting from law 833/78, without there being any careful evaluation of the impact and the real effects of these interventions. only subscribers can see the full article

This contribution is intended to answer two questions: 1) what do we mean by cost-performance, efficiency and efficacy; 2) why do we now talk about appropriateness. We can define these terms as follows: * cost-performance means conforming and responding to principles of economics in the sense of parsimony and saving; * efficiency is the situation of maximum productive capacity, at minimum possible costs, in a combination of production or supply of goods and/or services; * efficacy is the capacity to fully produce the desired effect and the obtaining of it. Nothing can be managed, still less managed well, that is, there can be no administration of the goods and/or interests for others, if the principles of cost-performance, efficiency and efficacy are not borne in mind and applied. only subscribers can see the full article