JANUARY
1857_mossialos_intl_profiles_2015_v6
1857_mossialos_intl_profiles_2015_v6
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ITALY<br />
Organization of the Health System in Italy<br />
Parliament<br />
Administration and Planning Flows<br />
Government<br />
Contractual agreements<br />
Ministry of<br />
University<br />
and Scientific<br />
Research<br />
Universities and<br />
clinical departments<br />
Teaching Hospitals<br />
Public pharmacies<br />
Health care district<br />
Ministry<br />
of Health<br />
Public Health Department<br />
National Institute<br />
of Public Health<br />
Regional<br />
Government<br />
Mental Health Department<br />
Agency for<br />
Regional Health<br />
Care Services<br />
National Health<br />
Council<br />
Research Hospitals<br />
(IRCCS)<br />
Public Hospital<br />
Enterprises<br />
Local Health Units<br />
Nursing homes and skilled<br />
nursing facilities<br />
LHU managed hospitals<br />
National<br />
Pharmaceutical<br />
Agency<br />
Private pharmacies<br />
General<br />
practitioners and<br />
paediatricians<br />
Private accredited<br />
hospitals<br />
Private accredited<br />
specialists<br />
Source: A. Donatini, Emilia-Romagna Regional Health Authority, 2014.<br />
Payment rates for hospital and outpatient specialist care are determined by each region, with national rates<br />
(determined by the Ministry of Health) as a reference.<br />
Some regional governments have established agencies to evaluate and monitor health care quality and to<br />
provide comparative effectiveness assessments and scientific support to regional health departments (see<br />
below). Regional governments periodically sign with the national government “Pacts for Health” linking<br />
additional resources to the achievement of health care planning and expenditure goals (see below).<br />
Safeguarding of patients’ rights has not been uniform and has depended on the level of effort of individual<br />
regions. Regions have implemented different models of empowerment: some through standing committees,<br />
which include members from citizens’ associations, as an institutional means of patient involvement, while others<br />
have emphasized systematic patient satisfaction surveys.<br />
Each public institution has an office for public relations (Ufficio Relazioni con il Pubblico) providing information<br />
to citizens and, in many cases, monitoring quality of services from the citizen’s point of view.<br />
What are the major strategies to ensure quality of care?<br />
National and regional governments, responsible for upholding quality, ensure that services included in the<br />
essential levels of care are provided and waiting times are monitored. Several regions have introduced programs<br />
for prioritizing delivery of care on the basis of clinical appropriateness of services prescribed and patient severity<br />
102<br />
The Commonwealth Fund