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Innovatori, indecisi, bisognosi o autonomi. I medici di medicina generale tra integrazione e accountability

Author

Listed:
  • Sara Barsanti
  • Manila Bonciani
  • Federico Vola
  • Luca Pirisi

Abstract

L?assistenza primaria in Italia sta subendo una radicale riforma con l?introduzione delle Aggregazioni Funzionali Territoriali (AFT), ovvero gruppi obbligatori di medici di medicina generale che si associano per rispondere insieme sia ai bisogni della popolazione assistita, sia per implementare le logiche del governo clinico. La Toscana gi? a partire del 2014 ? stata una delle prime Regioni a formalizzare le AFT negli Accordi Regionali e Aziendali e a nominare i coordinatori di AFT, ovvero medici di medicina generale che hanno il compito di guidare l?AFT nella programmazione e revisione di obiettivi di governo. A partire da un questionario rivolto ai coordinatori di AFT toscani, gli autori hanno analizzato la percezione dei coordinatori rispetto all?innovazione rappresentata dalla AFT, sia in termini di fiducia verso la logica di integrazione monoprofessionale (fiducia verso l?organizzazione), sia in termini di difficolt? percepita rispetto all?assolvimento del proprio incarico (fiducia verso il ruolo). Sulla base di tali criteri, gli autori hanno delineato, per il contesto della Toscana, 4 differenti gruppi di coordinatori con percezioni simili verso l?innovazione manageriale e organizzativa della medicina generale.

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  • Sara Barsanti & Manila Bonciani & Federico Vola & Luca Pirisi, 2016. "Innovatori, indecisi, bisognosi o autonomi. I medici di medicina generale tra integrazione e accountability," MECOSAN, FrancoAngeli Editore, vol. 2016(98), pages 9-39.
    • Handle: RePEc:fan:mesame:v:html10.3280/mesa2016-098002
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    References listed on IDEAS

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    1. Exworthy, M. & Wilkinson, E. K. & McColl, A. & Moore, M. & Roderick, P. & Smith, H. & Gabbay, J., 2003. "The role of performance indicators in changing the autonomy of the general practice profession in the UK," Social Science & Medicine, Elsevier, vol. 56(7), pages 1493-1504, April.
    2. Fattore, Giovanni & Frosini, Francesca & Salvatore, Domenico & Tozzi, Valeria, 2009. "Social network analysis in primary care: The impact of interactions on prescribing behaviour," Health Policy, Elsevier, vol. 92(2-3), pages 141-148, October.
    3. Tynkkynen, Liina-Kaisa & Chydenius, Miisa & Saloranta, Anna & Keskimäki, Ilmo, 2016. "Expanding choice of primary care in Finland: much debate but little change so far," Health Policy, Elsevier, vol. 120(3), pages 227-234.
    4. Contandriopoulos, Damien & Brousselle, Astrid & Breton, Mylaine & Sangster-Gormley, Esther & Kilpatrick, Kelley & Dubois, Carl-Ardy & Brault, Isabelle & Perroux, Mélanie, 2016. "Nurse practitioners, canaries in the mine of primary care reform," Health Policy, Elsevier, vol. 120(6), pages 682-689.
    5. Broadbent, Jane, 1992. "Change in organisations: A case study of the use of accounting information in the NHS," The British Accounting Review, Elsevier, vol. 24(4), pages 343-367.
    6. Fausto Di Vincenzo & Daniele Mascia & Dino Numerato & Domenico Salvatore, 2014. "Le reti sociali e i professionisti in sanit?: una review della letteratura," MECOSAN, FrancoAngeli Editore, vol. 2014(89), pages 71-84.
    7. repec:mpr:mprres:7634 is not listed on IDEAS
    8. Damiani, Gianfranco & Silvestrini, Giulia & Federico, Bruno & Cosentino, Mimma & Marvulli, Mariagrazia & Tirabassi, Federico & Ricciardi, Walter, 2013. "A systematic review on the effectiveness of group versus single-handed practice," Health Policy, Elsevier, vol. 113(1), pages 180-187.
    9. Manila Bonciani & Sara Barsanti & Daniela Matarrese, 2015. "Esperienze di integrazione nell?assistenza primaria basate sulla co-location dei servizi: quali prospettive per il modello della Casa della Salute?," MECOSAN, FrancoAngeli Editore, vol. 2015(96), pages 81-121.
    10. Erin Fries Taylor & Rachel M. Machta & David S. Meyers & Janice Genevro & Deborah N. Peikes, "undated". "Enhancing the Primary Care Team to Provide Redesigned Care: The Roles of Practice Facilitators and Care Managers," Mathematica Policy Research Reports b2897e3202c548999e765c7f9, Mathematica Policy Research.
    11. Visca, Modesta & Donatini, Andrea & Gini, Rosa & Federico, Bruno & Damiani, Gianfranco & Francesconi, Paolo & Grilli, Leonardo & Rampichini, Carla & Lapini, Gabriele & Zocchetti, Carlo & Di Stanislao,, 2013. "Group versus single handed primary care: A performance evaluation of the care delivered to chronic patients by Italian GPs," Health Policy, Elsevier, vol. 113(1), pages 188-198.
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    1. Luca Pirisi & Elisabetta Reginato, 2022. "La digitalizzazione a supporto del processo di implementazione del nuovo modello di assistenza territoriale della ASL di Sassari," MECOSAN, FrancoAngeli Editore, vol. 2022(123), pages 149-165.

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