Recovery Plan, a healthcare mission (part 2)

Planned investments include building and modernising the Italian National Health Service, both technologically and organisationally.

Proximity networks, facilities and telemedicine for territorial healthcare

The projects aim to improve territorial healthcare by enhancing the role of the patient, integrating care services in a "One Health" (holistic) approach focused on strengthening local health services. Planned investments include building and modernising the Italian National Health Service, both technologically and organisationally.

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The COVID-19 pandemic has made clear the universal importance of health as a fundamental public good. The Italian National Health Service continues to be recognised throughout the world as one of the most efficient systems which, in guaranteeing health as a fundamental right, manages to achieve good results (higher life expectancy at birth and lower mortality values than the averages for OECD countries) and, at the same time, manages to contain health expenditure.

Nonetheless, the Italian NHS during the COVID-19 pandemic showed elements of relative weakness and the persistence of significant disparities between Italian regions. The COVID-19 emergency has therefore reinforced the need to intervene and renew some key elements of the Italian National Healthcare System, also in view of structural (i.e. demographic) and current (i.e. epidemiological) trends.

The criticalities that emerged can be summarised as follows:

  1. an excessive gap between the levels of health provided by the Italian Regions, especially in terms of prevention, territorial care and - within these Regions - inequality between urban and other areas
  2. a poor capacity for integration between hospital services, local health services and social services
  3. a delay in the implementation of local health services and prevention services, also with significant disparities between Regions, especially in relation to hospital-territory integration;
  4. a poor synergy in the definition of prevention and response strategies of the health service with respect to environmental and climate risks, according to the so-called One Health approach (original document only available in Italian).

Moreover, the COVID-19 emergency highlighted the crucial importance of having technological/digital solutions for public health, strong digital skills and appropriate processes for care services.

A major acceleration of investments in the digitisation of the Italian NHS is therefore necessary, especially in the areas of telemedicine, management of primary care activities, outpatient visits, pre-triage, pre-screening, monitoring of patients treated at home, teleconsultation and digital collaboration between hospitals and health authorities for information management or between emergency rooms, intensive care and infectious diseases and territorial care.

The two main challenges

Given the current context, there are two main challenges. First, it aims to strengthen health care and the territorial health network, improving the quality and sustainability of home care, community care and long-term care, in order to ensure better levels of care throughout the country. To this end, it is also intended to address the fragmentation and lack of homogeneity of the health services offered in the various Italian Regions. The second challenge is to apply holistic approaches in the planning and management of social and health services and in the prevention of environment, climate and health.

Among the objectives presented in the document are:

Investment projects will cover:

  1. Community Health Houses to improve territorial healthcare.
  2. Home care as the first point of care for citizens.
  3. Strengthening intermediate healthcare and its structures (community hospital).
  4. Health, environment and climate: National reform plan and investments in public health for resilience and sustainable recovery.

Community Health Houses

Chronic diseases in 2019 affected almost 40% of the Italian population. The number of chronically ill people is steadily increasing, with a significant impact on the future need to commit health, economic and social resources. In addition, there are 3.1 million people with disabilities in the country, i.e. 5.2% of the Italian population. Of these, almost 1.5 million are over 75 years old (i.e. more than 20% of the population in that age group). Finally, Italy has the highest share of elderly population compared to the EU average - about 23.2% of the population is over 65 and 3.6% over 80 - and life expectancy at birth is among the highest in the world, which translates into long-term pressure on the National Health Service.

The presence, in this context, of uncoordinated health and social-assistance interventions on the territory, the slow increase in local health structures in the Regions and/or the slow increase in the services offered in non-hospital structures, are causes of inefficiency and hinder the quality of the service provided and perceived by the citizens. This problem has been particularly highlighted by the COVID-19 emergency, and the need for geographically dispersed facilities is now evident, in order to avoid excessive recourse to hospital care, especially for non-urgent and unpostponable treatments.

The answer to this need is identified in the "Community Health House", an organisational solution that acts as a primary care hub, capable of filtering access to acute facilities and coordinating and integrating all the care services for chronic patients already present in the area.

It will be the single point of access to health services for the citizen and will develop a single health database for each citizen, with the aim of ensuring equal treatment in care and access to such facilities for all residents in the country.

In the Health House, citizens will be able to:

Specifically, the objective of the investment is to activate 2,575 Health Houses, in order to guarantee equal access, territorial proximity and quality of care. The investment aims at integrating social and health services for comprehensive personal care. Wider and more inclusive home and community-based care and long-term care are key to providing support to people with disabilities and other disadvantaged groups.

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Click on the image to download the Recovery Plan draft

Reference:
Draft Recovery Plan "Mission 6 - Healthcare. M6C1 - Proximity networks, facilities and telemedicine for territorial healthcare assistance. M6C2 - Innovation, research and digitalisation of national healthcare service".

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