Quale rilevanza dei modelli regolativi regionali? La questione lombarda nella crisi sanitaria Covid-19

Arlotti, Marco; Marzulli, Michele

doi:10.3280/ses2021-002-s1012

Cited by 4 publications

(3 citation statements)

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“…Over the last years, this region has indeed implemented a health policy increasingly centred on both large hospitals and the private market [103]. The excellence of the hospital system and specialist medicine have in turn weakened the asset of territorial assistance, in reason of strong long-lasting disinvestments in this respect, with difficulties in dealing with the pandemic health emergency, and heavy consequences on the support to be provided to COVID-19 patients, especially older people [104]. Thus, in Italy the pandemic led overall to saturation of hospitals and acceleration in deaths, mainly of older people, despite a well-developed healthcare system in several affected regions, especially in the North of the country [44].…”

Section: Plos Onementioning

confidence: 99%

The impact of the COVID-19 pandemic on frail older people ageing in place alone in two Italian cities: Functional limitations, care arrangements and available services

Melchiorre,

Cerea,

Socci

et al. 2024

PLoS ONE

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The study aimed to explore and compare effects of lockdown, due to the COVID-19 pandemic in 2020, on frail older people living alone at home in Brescia and Ancona, two urban cities located respectively in Northern and Central Italy. This country was the Western epicenter of the first wave of the pandemic (February-May 2020), which affected the two cities differently as for infections, with a more severe impact on the former. A follow-up study of the IN-AGE research project (2019) was carried out in July-September 2020, by means of telephone interviews, involving 41 respondents. Semi-structured questions focused on the effects of the first wave of the pandemic on their mobility and functional limitations, available care arrangements, and access to health services. The lockdown and social distancing measures overall negatively impacted on frail older people living alone, to a different extent in Ancona and Brescia, with a better resilience of home care services in Brescia, and a greater support from the family in Ancona, where however major problems in accessing health services also emerged. Even though the study was exploratory only, with a small sample that cannot be considered as representative of the population, and despite differences between the two cities, findings overall suggested that enhancing home care services, and supporting older people in accessing health services, could allow ageing in place, especially in emergency times.

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Section: Plos Onementioning

confidence: 99%

The impact of the COVID-19 pandemic on frail older people ageing in place alone in two Italian cities: Functional limitations, care arrangements and available services

Melchiorre,

Cerea,

Socci

et al. 2024

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…However, with regard to health, the main difference between the two cities regards the fear of not receiving adequate assistance in the event of contracting the COVID-19 virus, more expressed in Ancona and by no older people in Brescia. A result that is surprising at first glance, in consideration of the structural weaknesses of the Lombard primary care as for territorial coverage, which strongly emerged during the first phase of the emergency [74]. This can be explained, however, by the high traditional performance of the healthcare system in this region, which, in its collective representation, is considered one of the best in Italy because of its proven excellence in the hospital field, specialist medicine, and overall high level of health services [75].…”

Section: Fear For the Pandemicmentioning

confidence: 99%

Social Networks, Use of Communication Technology, and Loneliness of Frail Older People Ageing in Place in Italy: The Impact of the COVID-19 Pandemic

Melchiorre,

Cerea,

Socci

et al. 2023

Sustainability

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The study explored how the lockdown, following the first wave of the COVID-19 pandemic in Italy (February–May 2020), impacted frail older people needing Long-Term Care (LTC) and living alone at home in Brescia and Ancona. These two urban cities were differently affected by the pandemic, with a major degree of infections and deaths in the former. In July–September 2020, a follow-up study of the IN-AGE research project (2019) was carried out in both cities, involving 41 older respondents by telephone, to detect the impact of the health emergency on their social networks, use of communication technology, social isolation, and loneliness. Findings showed that the use of communication tools was overall expanded, and seniors increased telephone (TEL) contacts, especially in Ancona. In both cities, fears for the infection emerged too, and mainly in Ancona than Brescia, several cases of worsened perceived loneliness were detected. Despite the exploratory/descriptive nature of the study, with a not-representative sample of the population and notwithstanding some differences among cities, the findings stressed the risk of isolation and loneliness for seniors living alone. This risk was buffered by the use of communication technology during the lockdown, but more interventions allowing sustainable healthy ageing (HA) in place and enhancing healthy behaviours, especially in emergency situations, are needed.

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“…The debate on healthcare at the time of COVID has highlighted in various ways that the better stability of regional systems like those of Veneto and Emilia Romagna is linked to a wider and more solid territorial system of health-care provision. A contrasting case is exemplified by the situation in Lombardy, where the reorganization implemented in the past years has exasperated the 'hospital-centered' architecture of the health system and further impoverished the endowment of community based services (Arlotti, Marzulli, 2021). As already said, it is the regulatory model on which Lombard healthcare is based that explains the massive disinvestment in the territory: competition as a guiding principle of the architecture of the supply system strongly discourages investment in less profitable 'markets' -such as, precisely, prevention and community health -and which are therefore less attractive for individuals.…”

Section: The Fading Territorial Health Servicesmentioning

confidence: 99%

The Italian National Health Service: Universalism, Marketization and the Fading of Territorialization

Bifulco

Neri

2022

Forum for Social Economics

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At the time of its inception, in 1978, prevention and primary care were set as fundamental pillars of the Italian National Health Service (NHS), emphasizing the collective and social dimension of health. These principles were progressively neglected over the following four decades. Marketization, managed competition and managerialization privileged the individualized, highly specialized healthcare services mainly provided in hospitals, to the detriment of local outpatient and primary care services. After 2008-09, austerity policies exacerbated this situation determining under-financing as well as structural and staff shortages, while increasing tensions arose between the central government and Regions in the decentralized NHS. In 2020-21, the pandemic highlighted these critical issues. The need to develop a universal and strong outpatient, primary and community care system became evident in order to ensure the appropriateness and quality of foundational health services. This requires the State to play a more prominent role in the NHS governance.

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Quale rilevanza dei modelli regolativi regionali? La questione lombarda nella crisi sanitaria Covid-19

Cited by 4 publications

References 0 publications

The impact of the COVID-19 pandemic on frail older people ageing in place alone in two Italian cities: Functional limitations, care arrangements and available services

The impact of the COVID-19 pandemic on frail older people ageing in place alone in two Italian cities: Functional limitations, care arrangements and available services

Social Networks, Use of Communication Technology, and Loneliness of Frail Older People Ageing in Place in Italy: The Impact of the COVID-19 Pandemic

The Italian National Health Service: Universalism, Marketization and the Fading of Territorialization

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