意大利利古里亚初级医疗保健的新组织模式。见解和影响。

Filippo Ansaldi, Matteo Astengo, Alberto Battaglini, Federico Grammatico, Francesca Marchini, Andrea Fiorano, Silvia Allegretti, Irene Schenone, Daniela Amicizia
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摘要

在多年的成本控制政策之后,意大利国家医疗服务体系(NHS)现在有了改变和改进的机会,这尤其要归功于国家恢复和复原计划(NRRP)。该计划是改革的催化剂,划拨了大量资金用于加强近距离网络、设施和远程医疗,以促进地区医疗保健。任务 6 专门针对卫生保健,重点是整合初级保健、医院和专科护理网络,强调健全的初级保健系统的重要性。为与 NRRP 目标保持一致,利古里亚模式引入了创新结构,如社区之家 (CdCs)、社区医院 (OdCs) 和地区运营中心 (COTs)。这些相互关联的组成部分形成了一个动态网络,旨在提高医疗服务的可及性,防止不适当的入院治疗,并促进病人的有效转院。该模式优先考虑多学科协作、社区参与和社会医疗服务一体化。尽管国家康复计划为基础设施提供了大量资金,但人员配备和人力资源方面的挑战依然存在。社会和流行病学背景凸显了人们对改革的经济可行性、潜在的劳动力短缺以及更新监管框架的必要性的担忧。总之,利古里亚模式是对大流行病暴露出的结构性弱点的积极应对,与强调初级保健、预防和社区服务的国际趋势相一致。
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A new organizational model of primary healthcare in Liguria, Italy. Insights and implications.

After years of cost-containment policies, the Italian National Health Service (NHS) has now the chance to change and improve, especially thanks to the National Recovery and Resilience Plan (NRRP). The plan serves as a catalyst for reform, allocating substantial funds to reinforce proximity networks, facilities, and telemedicine for territorial healthcare. Mission 6, specifically dedicated to health, focuses on integrating primary healthcare, hospital, and specialty care networks, underscoring the importance of a robust primary healthcare system. In alignment with NRRP objectives, the Ligurian model introduces innovative structures, such as Community Houses (CdCs), Community Hospitals (OdCs), and Territorial Operation Centres (COTs). These interconnected components form a dynamic network designed to enhance healthcare accessibility, prevent inappropriate hospital admissions, and facilitate efficient patient transitions. The model prioritizes multidisciplinary collaboration, community engagement, and the integration of socio-healthcare services. Despite substantial NRRP funding for infrastructure, challenges related to staffing and human resources persist. The social and epidemiological context highlights concern about the economic feasibility of the reform, potential workforce shortages, and the imperative for updated regulatory frameworks. The strategic reallocation of personnel from acute hospitals to new facilities is crucial, requiring meticulous workforce planning, role definitions, and trainingIn conclusion, the Ligurian model emerges as a proactive response to the structural vulnerabilities exposed by the pandemic, aligning with international trends in emphasizing primary care, prevention, and community-based services.

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