196,143 research outputs found
Le configurazioni mutevoli delle professioni sanitarie
No full textDalla seconda metà del Novecento a oggi sono mutate le domande di salute e le risposte che a esse sono state date, ma sono cambiate altresì le professioni sanitarie. Esse hanno subito trasformazioni nei propri profili di genere e di generazione, nel proprio posizionamento sociale (di potere, status e classe), quando anche nella propria fisionomia professionale (le caratteristiche cioè del loro professionalismo). Di tali trasformazioni si darà conto, illustrando dapprima i fattori di cambiamento (par. 1); proponendo, quindi, uno specifico schema di analisi, cioè quello sviluppato da Norbert Elias (par. 2); rilevando, poi, le implicazioni derivanti dal managerialismo, dal consumerismo e dalle nuove tecnologie sanitarie (par. 3); concludendo, infine, con i maggiori mutamenti a livello sociodemografico (par. 4)
Dynamics between doctors and managers in the Italian National Health Care System
No full textThis article focuses on the changes in the Italian NHS by concentrating on patterns in the managerialisation of doctors. It addresses a series of shortcomings in studies on the response by doctors to managerialisation. The first is a shortcoming of theoretical and analytical nature. It is necessary to adopt a broader perspective whereby analysis considers not only the interaction between doctors and managers, but also the public control and regulation agencies that operate in that field. The second shortcoming is a methodological one. The literature on managerialisation is more theoretical than applied. It is necessary to adopt a strategy based on a plurality of methodologies and sources in order to focus attention on a national case (Italy in the present study), discussing the changes over time (from the beginning of managerialisation until today) and considering different groups within the medical profession. The outcome is a complex picture of the dynamics between doctors and managers which foregrounds the managerial co-optation processes of a small group of national health service doctors, the transition from strategic adaptation to forms of resistance against managerialisation by the majority of Italian NHS doctors, and the emergence of restratification processes among selfemployed doctors working with the NHS
The Role of Private Providers in the Italian Public Health Care System
No full textThe paper addresses three different questions in relation to public-private partnership in health care. What the main public-private partnerships models in health care in Italy are and how they have evolved over time. How differences in the adoption of public-private partnership models can be explained. The possible impact of different public-private partnership models on the overall institutional performance of NHS. On one side the article shows how important is to adopt also a path dependency approach to account for most recent transformations in the public-private interaction. On the other the paper argues that there is not a significant relationship between diffusion of private provision and NHS performance: the outcome of public-private partnerships depend quite strongly on public governance capacity
Is decentralization good for your health? Transformations in the Italian NHS
No full textDecentralization is a cornerstone of health policy reforms across Europe and beyond.
This article analyses some of the effects of decentralization using the Italian National
Health System (NHS) as a case study. The authors evaluate the risks of welfare state
retrenchment and the rise of territorial inequalities in accessing healthcare, using document
analysis, secondary sources and micro-data elaboration. The analysis does not confirm
an overall welfare state retrenchment, but reveals an increase in territorial inequalities.
The results highlight a paradox: if decentralization is to be implemented in a country
with strong territorial socioeconomic divides and a critical financial situation, it needs a
strong central government in order to support and control local authorities. Otherwise,
decentralization may cause a zero-sum game where the gains for the better-off regions
counterbalance the losses in performance of the weaker ones; a situation which could
lead to the growth of social inequalities, including gender inequalities
Medici e politiche sanitarie nell’Europa meridionale. Un’ipotesi interpretativa.
No full textin M. Ambrosini e B. Beccali (a cura di) Lavoro e nuova cittadinanza. Cittadinanza e nuovi lavor
The first pandemic year: Continuity or change in two Italian Regional Healthcare Systems?
No full textIn recent years, social policy studies have increasingly focused on renewed State activism. The pandemic crisis called the State and central government to play an active role, even in highly decentralised healthcare systems. This involves two main issues: the importance of studying health policy at sub-national level and the analysis of the processes of institutional and organizational change. As to institutional change, literature on path dependency has been criticized for its deterministic view of the reproduction of institutions. More attention to the processual dimension is needed, as well as to the ways by which institutional arrangements are re-negotiated and translated into policies adopted under the pressure of a catastrophe. We hypothesise that, first, within the responses to pandemic, a process that develops through different temporal phases can be identified; second, that, in the initial phases, the weight of path dependency is stronger due to the proximity to the past and the lack of different tools that they still have to be forged. There could be limited innovations, according to which development trajectories are characterized by elements of continuity mixed with some changes. This would mean identifying, at least initially, incremental forms of change, for example by sedimentation (institutional layering) or by conversion even in the face of a strong impact event. The analysis of two regional regulation adopted (in Lombardy and Marche) to implement the national regulations, during 2020, shows that forms of institutional change through sedimentation or conversion can be identified
The Role of Private Providers in the Italian Public Health Care System
No full textThe paper addresses three different questions in relation to public-private partnership in health care. What the main public-private partnerships models in health care in Italy are and how they have evolved over time. How differences in the adoption of public-private partnership models can be explained. The possible impact of different public-private partnership models on the overall institutional performance of NHS. On one side the article shows how important is to adopt also a path dependency approach to account for most recent transformations in the public-private interaction. On the other the paper argues that there is not a significant relationship between diffusion of private provision and NHS performance: the outcome of public-private partnerships depend quite strongly on public governance capacity
Control, competition and cooperation in European Health Systems: points of contact between Health Policy and Industrial Policy
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