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Processo di decentramento del SSN ed evoluzione dell?equit? interregionale nell?assistenza sanitaria nel periodo 2001-2012

Author

Listed:
  • Antonio Nuzzo
  • Flavia Carle
  • Eugenio Anessi Pessina

Abstract

Nel contesto dei servizi sanitari, le politiche condotte a livello sia internazionale sia nazionale hanno portato alla ribalta il concetto di decentramento dei sistemi di governance. In Italia, in particolare, con l?approvazione del D.Lgs. n. 56 del 2000 sul federalismo fiscale e la modifica del Titolo V della Costituzione (Legge Costituzionale n. 3 del 2001), le regioni hanno ottenuto maggiori competenze politicoamministrative, organizzative e gestionali anche in ambito sanitario. A livello internazionale diversi sono gli studi che hanno approfondito la tematica dell?equita all?interno di un sistema sanitario decentrato che, nel contesto italiano, si sostanzia nella garanzia di un?equa erogazione dei livelli essenziali di assistenza (LEA) tra le diverse regioni. L?equita rappresenta un principio costituzionale, perseguito dal livello centrale che ne valuta e monitora il rispetto, tra l?altro, attraverso il set di indicatori della Griglia LEA. A partire dagli indicatori della Griglia LEA, attraverso un?analisi multidimensionale per componenti principali, lo studio analizza l?evoluzione della differenziazione interregionale nell?assistenza sanitaria (prevenzione, assistenza ospedaliera, assistenza territoriale) tra il 2001 e il 2012, quando si e maggiormente sviluppato il processo di decentramento sanitario. In linea con la letteratura internazionale, questa analisi coglie l?esistenza di situazioni di differenziazione interregionale. Si osserva in particolare: 1) una differenziazione interregionale sulle componenti delle coperture vaccinali, della performance nell?assistenza ospedaliera e dell?assistenza distrettuale per disabili; 2) una persistente differenziazione nell?assistenza ospedaliera tra centro-nord e sud; 3) un trend in peggioramento per le regioni a statuto speciale e province autonome sia nell?erogazione di assistenza ospedaliera sia sulle coperture vaccinali. I risultati dello studio, innovativo per dimensioni dell?equita esplorate e dati a disposizione, giustificano l?intervento del livello centrale nel suo ruolo di garante dell?e- quit? territoriale rispetto all?erogazione dei livelli essenziali di assistenza.

Suggested Citation

  • Antonio Nuzzo & Flavia Carle & Eugenio Anessi Pessina, 2018. "Processo di decentramento del SSN ed evoluzione dell?equit? interregionale nell?assistenza sanitaria nel periodo 2001-2012," MECOSAN, FrancoAngeli Editore, vol. 2018(108), pages 9-34.
    • Handle: RePEc:fan:mesame:v:html10.3280/mesa2018-108002
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    References listed on IDEAS

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    2. Niccol? Persiani & Martina Giusti & Maria Jose Caldes & Afef Hagi, 2022. "Il contributo del management alla definizione della strategia di decentramento del Servizio Sanitario: il caso del Servizio Sanitario Tunisino," MECOSAN, FrancoAngeli Editore, vol. 2022(122), pages 85-103.

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