1,721,005 research outputs found
La flessibilità del lavoro nel Servizio Sanitario Nazionale prima e durante la pandemia da Covid-19
No full textThe first thesis of the article is that the public health sector experiences, after the financial crisis of 2007 and until 2019, a process of increasing labour flexibility. This is a numerical flexibility (in the number of employees and in the type of employment contracts), rather than a functional flexibility. Indeed, the latter is difficult to imple- ment in a sector based on high proportion of professional work, with corporatist forms of self-regulation. The second thesis, relating to the pandemic period, argues that between 2020 and 2021 even more flexible labour policies in the NHS were produced, with further deregulation dictated by the emergency. The concluding question concerns to what extent the Recovery and Resilience Plan (PNRR) issued in 2021 and the new Budget Law for 2022 may be able to reverse the long cycle of labour flexibilisation that entered the public health sector more and more
Si può parlare di declino della professione medica in Italia? Elementi di analisi e di riflessione
No full text
DM 77: quale sviluppo per l’assistenza territoriale?|MD 77: WHAT KIND OF DEVELOPMENT FOR TERRITORIAL CARE?
No full textMinisterial Decree (MD) 77, issued in June 2022 tends to address and resolve three critical nodes of public territorial assistance. They concern the lack of uniform provision throughout the country of the essential levels of care (LEAs); the limited development of territorial services, especially in the less virtuous Regions; the lack of flexibility of these services in relation to the population’s care and health needs, with particular regard to chronic/fragility and disability conditions. The aim of the MD is to define uniform mod- els and standards for the development of territorial care in the National Health Service (NHS). The underlying principles are those of Law 833 (universality, equality and equity). In addition, three other principles have been added according to which the new system must be: close to the community, designed for people and with people. On the whole, the MD 77 presents itself as a fundamental point in the reorganization, in terms of uniformity, of the NHS, not without major problems in its application
Una catastrofe vitale? Le scelte di politica sanitaria per far fronte al Covid-19
No full textIn early 2020, the Italian National Health Service (NHS) was affected by four kinds of
distortion: cultural, penalising health prevention; functional, giving priority to hospital
care; institutional, with a decentralised system lacking inter-regional solidarity; redistributive,
tending to a differentiated universalism. These distortions strongly conditioned its
ability to respond to the Covid-19 pandemic. Selected measures represented mostly simple
adjustments adopted in the emergency and determined by path dependency. Although
they share the same critical features, reforms included in the 2021 National Recovery and
Resilience Plan attempt a more significant action on the distortions, in order to pursue
wider and partly structural changes
Tackling the Covid-19 pandemic: The Italian national health service in a comparative perspective
No full textThe article deals with the issue of public health policy strategies adopted by various countries and, as regards Italy, by the two Northern regions that were first affected by the Covid-19, Lombardy and Veneto, during the first pandemic wave of winter-spring 2020. In the first part, the three main public health policy strategies to counter the Covid-19 pandemic that emerged from the debate among public health experts at an international level are outlined. On this basis, some paradigmatic cases are identified that exemplify the conditions and consequences in terms of morbidity and mortality that these strategies have entailed. The second part focuses on the Italian case and on the differences that emerge, in terms of mortality, in the two regions (Lombardy and Veneto) as a result, among other things, of the health policy choices made by the respective regional governments. The hypothesis that we intend to support is that these policies and their effects in terms of mortality are the reflection of a plurality of epidemiological, environmental and clinical factors, but also the result of the interaction between the specific structuring of national/regional health care systems (path dependence) and the choices made to counter the pandemic emergency (agency)
Le service de santé national à l'épreuve de l'efficacité. Le rôle de la médecine généraliste en Italie
No full textI medici in Italia: motivazioni, autonomia, appartenenza
No full textIn this book the results of a research on physicians in Italy have been discussed. The research involved a survey of some 900 doctors working in three pivotal (in terms of sociological representation) counties of the country: Turin (representing the North-West); Ancona (Center-North-East); and Cosenza (South). The sample was stratified by sex, age and specialty.
The main question to be asked for is: what are the doctors’ motivations for practicing medicine and can these motivations be generalized into weberian ideal types as to make a typology of physicians? And how these motivational profiles affect, and in their turn are affected by, socio-demographic and other (i. e. political) variables?
Summing up, four motivational factors have been devised: the economic-instrumental, the scientific, the status-traditional and the altruistic-humanitarian. As a result two ideal-types of medical doctors stood out and they are characterized by different mixes of the four factors and by different sizes: the physicians “by passion” (almost half of all doctors, with a strong prevalence of the scientific and altruistic-humanitarian attitudes and a weak presence of the other two), “by profession” (almost 30%, with a balanced degree of each kind of attitude). Four more ideal types came out but were much less diffused: the physicians “by chance” (less than 10%, every attitude is weak), “by vocation, or by calling” (with a strong prevalence of the scientific attitude), “by compassion” (with a strong prevalence of the altruistic-humanitarian attitude) and “by greed” (a residual group located in Ancona, with a strong prevalence of the economic-instrumental attitude).
Qual è oggi il ruolo del medico? Quali motivazioni lo spingono a scegliere la professione? Che stile di vita conduce? Come percepisce le sfide poste dai diversi attori del sistema sanitario (pazienti, manager, politici)? Come sono cambiati i rapporti con i pazienti? E quelli con le altre professioni sanitarie e con le medicine non convenzionali? Esiste ancora un’identità professionale unitaria, un senso di appartenenza condiviso, oppure la professione medica è frantumata in segmenti fra loro separati? Basato su un’inchiesta che ha coinvolto circa 900 medici iscritti agli Ordini professionali di tre province italiane (Ancona, Cosenza e Torino), il volume indaga su tutti questi interrogativi. Dalle risposte fornite emerge un quadro completo dei diversi modi di essere e sentirsi medico oggi in Italia. L’analisi delle motivazioni nella scelta della professione ha aiutato a costruire una rassegna di tali modi, mentre la riflessione sull’autonomia professionale ha consentito di definire meglio la portata delle sfide esterne e, soprattutto, di capire perché i manager siano percepiti come gli «avversari» più pericolosi. Il volume si conclude con una scommessa sul futuro e prova ad immaginare le chances di successo di un nuovo professionalismo che sia in grado di esercitare un ruolo di «leadership morale», ossia di farsi carico dei fini generali della sanità e degli interessi della collettività. Tale possibilità si gioca fra i condizionamenti che i medici subiscono a livello individuale e la capacità di determinazione del proprio destino che la professione possiede come attore collettivo. Per questo, come direbbe il dottor Manson della «Cittadella» di Cronin, sarebbe decisivo un gruppo di professionisti «concordi, non concorrenti»
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