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health system

The Costs of the Failure to Integrate Social and Health Care

Articolo scritto da:

That health service costs tend to increase staggeringly is well known. The most recent forecast of PricewaterhouseCoopers Health Research Institute estimates a tripling of its impact on Gdp in the next fifteen years, reaching 21% in the USA and an average of 16% in other OECD countries. Italy’s relatively favourable position at 8.5% will tend to be eroded, if for no other reason than the worldwide tendency of health service consumption, supply systems and costs to converge. only subscribers can see the full article

Italian Health System: Work in Progress between Decentralization and the Impact of the Eu

Articolo scritto da:

in the issue
Nhs
The crisis of the State-nation led to a consolidation of sub-national levels of government. This reinforcement has conditioned recent developments in the welfare state, and particularly in health policy. With reference to the Italian case, the article illustrates the main changes brought into force by the reforms of 1992-93 and of 1999 in terms of the «regionalization» of the health system, and outlines the main steps that led to fiscal federalism, enhancing regional financial autonomy. The closing paragraph takes into consideration possible implications of the process of European integration and, more specifically, the adoption of the Open method of co-ordination on the evolution of the regional health systems.only subscribers can see the full article

Italy. National and Regional Health System: Debts and Equity

Articolo scritto da:

in the issue
Europe and Regions
Tax federalism in Italy is closing in on us, while the gap between North and South increases. In the welfare system the gap concerns both essential levels of services as well as the economic-financial situation. Analysing the balance sheets of recent years and some indicators of the state of organisation of the regional health services, we can see how the deficit in many Regions is not due to under-financing so much as to different planning and organisational choices. In the less virtuous Regions there is an extremely close link between deficits and distortions in services, while in the more virtuous Regions the positive balance results are accompanied by indicators that show better organisation and greater appropriateness. This is confirmed by the plans of the six Regions with serious deficits for dealing with the situation. This shows the importance of local governance and at the same time the need, particularly in a federal country, for strong national control to guarantee uniform essential services throughout the country. only subscribers can see the full article

Towards the Reinterpretation of the Managed Competition Model?

Articolo scritto da:

in the issue
Nhs
During the 90s, the managed competition model, or quasi-market, was the main reference for the reform of European health systems. The concrete application of this organisational model - aimed at reallocating incentives between financiers, producers and users to guarantee the appropriateness of services, the costs containment and the efficient allocation of resources - has occurred even with numerous variants from the starting proposal and through reforms that followed one another discontinuously, at times emphasising and at other times undermining the pro-competition objectives. In this perspective, the paper proposes an analysis of the reforms experienced over the past few years in England and Italy and investigates the reasons that encouraged these countries to progressively reduce the role of competition, preferring negotiated schemes that were considered to be more compatible with solidarity principles that characterized European public health systems.only subscribers can see the full article

Betty Leone

Articolo scritto da:

I welcome the decision to devote a session of the seminar on health and welfare policies to issues related to a proper definition of informative system aimed to transferring knowledge among health workers, and from them to the general public, and vice versa. The debate is not new. On the contrary, it characterized the ’70’s and ’80’s in the period of health service reform and it was later taken up again during the discussions that led to the law (no. 328/2000) on welfare reform. Indeed, it is clear that this subject meets various needs. The first is that of identifying the needs to which we are to respond: this is an essential function if the services are not to fall into a merely self-referential logic rather than responding to the need to meet the general public’s requirements effectively. only subscribers can see the full article

Health Spending: Proposals for a New State-Region Pact in Italy

Articolo scritto da:

in the issue
Nhs
In the paper the author analyses the Italian Health spending in relation to public spending, and proposes a new accountability pact between central government and the regions, aimed at relaunching the National Health Service. Following an historical overview of the foundation of the Nhs and the reforms in the 70s and 90s, the relation between funding and spending from 1999 to 2004 is analysed in the light of documents produced by Institutions and Research Institutes, and compared with other European countries. The paper also presents a detailed analysis of health legislation concerning the regions adherence to the Stability Pact, the agreements signed at the State-Region Conference and the critical financial situations presently registered. Lastly, it examines article 119 of Title V of the Constitution and the new funding system of local authorities which it introduces.only subscribers can see the full article

Italy. National and regional health services: deficits and fairness

Articolo scritto da:

in the issue
The Italian case
Tax federalism in Italy is around the corner, while the gap between North and South increases. In the health and welfare system the gap concerns both essential service levels and the economic-financial situation. Analysing the running costs in the last few years and some indicators of the state of organisation of the regional health services, we can see how the deficit in many Regions is not due to under-financing so much as to different planning and organisational choices. In the less virtuous Regions there is an extremely close connection between deficits and distortions in the supply of seronly subscribers can see the full article
Keywords: federalism :: Italy :: health system :: deficit ::

Accreditation in Health: Regional Cases

Articolo scritto da:

in the issue
Nhs
The article analyses the theme of institutional accreditation in Italy, its implementation problems at the regional level in the framework provided in national legislation, and the experience of two regions, Emilia Romagna and Lombardia, which developed different accreditation models. In order to do this, national indications and the role assigned by the norm to the regions on accreditation are considered, together with the delays of the central level and those connected to the process of power devolution to the regions culminating in the modification of Title V of the Constitution. The analysis of some economic, cultural and political problems within the regions, which have influenced the modalities and start-up times of accreditation policies, introduces the accreditation models of Emilia Romagna and Lombardia, that are examined on the basis of different responses given to common critical aspects.only subscribers can see the full article

Health System and Immigration Needs

Articolo scritto da:

in the issue
Migration
Epidemiological data are not sufficient to describe and explain the health conditions of the immigrant population living in Italy with or without an official stay permit. Present information flows are numerous but insufficient and inadequate, lacking any connection with the survey of socio-demographic data and the needs of some groups of users who are in particularly vulnerable conditions. Through the results of a study conducted on data of the Social Information System of the Caritas Diocesana of Rome, the necessity to support and promote the creation of integrated socio-health information systems clearly emerges.only subscribers can see the full article

Health Cost of Ageing: Truth, Myths and Clichés

in the issue
Nhs
The heavy burden of health spending on elderly care is common-place in the preoccupations of policy makers and politicians, and is constantly the focus of media attention. The attention on this subject is however rather ambivalent: stress is not placed on the «physiology» of growth in investments for a part of society that «obviously» expresses several needs and is entitled to corresponding rights; the objective complexity of the problem is presented in such a way as to make the solutions appear increasingly more difficult and not due, with the consequent rise in cultural, political and cognitive marginalisation. Analysing four model scenarios, operative solutions, feasible through a participatory way, are indicated at both the local and general levels.only subscribers can see the full article