https://doi.org/10.4081/mem.2008.265

Aspetti evolutivi ed implicazioni etiche della legge 833

V. 57 N. 6 (2008)
Pubblicato: dicembre 30, 2008
Sistema sanitario italiano, storia, etica, Italia / National Health Service, history, ethics, Italy
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Autori

Walter Ricciardi
wricciardi@rm.unicatt.it
Facoltà di Medicina e Chirurgia "A. Gemelli", Università Cattolica del Sacro Cuore, Roma, Italy.
Secondo le conclusioni del Rapporto 2000 dell'Organizzazione Mondiale della Sanità l'Italia aveva il secondo miglior sistema sanitario al mondo e gli Italiani una delle più elevate aspettative di vita del pianeta, ma dal 2001, in seguito ad una riforma costituzionale, le 19 regioni e le due province autonome hanno acquisito una fortissima autonomia in tema di programmazione, organizzazione e gestione dei servizi sanitari che viene esercitata con grandissima eterogeneità. Queste variazioni regionali riflettono (ed accentuano) le differenze di contesto politico, economico e culturale che caratterizzano le diverse aree del nostro Paese. Un'analisi comparata recente ha evidenziato che 14 delle 21 regioni e province autonome offrono servizi sanitari adeguati ai cittadini in un quadro di compatibilità finanziaria, ma anche che 6 regioni sono in profonda crisi e sull'orlo di una catastrofe finanziaria. Questo lavoro analizza l'evoluzione del sistema sanitario italiano e le sue performance a discutere sulle sfide che lo coinvolgono, in primis quella di contenere i costi e garantire un equo sistema di offerta di servizi a tutti i cittadini.
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According to the conclusions of the World Health Organisation's 2000 report Italy had the second best health system in the world with Italians having one of the highest life expectancy, but since 2001 the 19 Italian Regions and 2 Autonomous Provinces exercise their autonomy very differently, with Northern regions being more successful in establishing effective structures of health care delivery, management and monitoring, compared to the regions in the South. This regional variation in health care reflects (and exacerbates) differences of contextual, i.e. political, economic and cultural factors as well as differences between regional health systems. A recent survey showed that in 14 of the 21 Regions and Autonomous Provinces the system is fairly well performing and well perceived by citizens but also that 6 Regions are on the verge of financial and service breakdown. This article outlines the structure of Italy health system, analyses its performance and discusses the challenges it faces, not least in trying to contain costs and offer equitable care to all citizens.

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Ricciardi, W. (2008). Aspetti evolutivi ed implicazioni etiche della legge 833. Medicina E Morale, 57(6). https://doi.org/10.4081/mem.2008.265

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