Sustainability and Resilience in the Italian Health System
Financing
Workforce
Medicines and technology
Service delivery
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Recommendation 1F: to revise the role of general practitioners within a consistent primary care framework.
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Recommendation 1G: to increase the structural and organisational capacity to respond to the needs of controlling epidemics and pandemics.
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Recommendation 2A: to enrich the inter-regional fund allocation formula to consider differences in terms of social deprivation, education, employability and house and family conditions that still exist among Italian regions.
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Recommendations 2B: to reduce out-of-pocket private expenditures and facilitate access to integrated funds via tax incentives.
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Recommendation 2C: to introduce value-based payment models.
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Recommendation 2D: To introduce measures to mitigate budgetary siloes, and develop a health expenditure forecast model.
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Recommendation 3A: to invest in healthcare workers, with adequate planning of the number of physicians, nurses and all other categories, enhancing the role of the Ministry of Health and of Regional Health Authorities. This recommendation includes a further increase in the number of contracts for resident physicians.
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Recommendation 3B: to simplify administrative procedures for the appointment of personnel during emergencies.
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Recommendation 3C: to care for the physical and mental well-being of health and social care staff, improving work conditions and reducing stress.
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Recommendation 3D: to continue the process of task-shifting between professional groups and foster team-based working models (see the case studies for more recommendations)
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Recommendation 3E: to develop a competence-based human resource management approach based on the definition of national standards for healthcare professionals, top and middle managers of healthcare organisation and regional health
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Recommendation 4A: to promote the establishment of a National Agency for Health Technology Assessment or at least ensure a stronger coordination among existing key actors in HTA. To overcome existing differences in the pattern of the introduction of drugs, vaccines, medical devices and new medical-surgical procedures, as well as telemedicine and digital solutions, ensuring equitable access to technology in all regions promoting patients’ and citizens’ involvement in key phases of the process.
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Recommendation 4B: to promote centralised investments for developing a national telemedicine infrastructure and establish a nationally based reimbursement scheme for telemedicine.
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Recommendation 4C: to participate in collective purchasing agreements with other EU countries.
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Recommendation 4D: to establish a resilience-oriented procurement strategy, also by supporting the national production of critical devices.
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Recommendation 5A: to continue to promote innovative solutions for the management of chronic conditions and the continuity of care (see case studies for further details).
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Recommendation 5B: to re-think the role of GPs and their systems, with the aim of their full integration in the healthcare system, also by providing specific role training. 8
