PMID: 9417539Jan 7, 1998Paper

The new administration approach of the National Health System: implications for internal medicine. The point of view of the internist

Minerva medica
G MarconG P Voltan

Abstract

The laws for the reform of the Italian National Health Service (502, 517) show marked bureaucratic and administrative patterns. The aim of these laws seems to be mainly a tight control of the health expenses instead of an improvement of health care. This choice is confirmed by the selection of indicators (DRG's) more fit for reimbursement rather than for quality assurance in health care. Moreover, these indicators are only a poor expression of the real medical status of the patients. The reform of the British NHS appears very similar to the Italian reform, mainly for the empowerment of managers to detriment of health professionals and of health care quality. The reforms designed with the collaboration of health workers may be more useful than the reforms based mainly upon bureaucratic principles. Only with this collaboration the double target of the reduction of health related costs and of the maintenance of an acceptable quality may be achieved. The professional associations and the academic world must be involved in the political and organisational choices related with health care, mainly in the fields of the setting of organisational standards and of the training of actual and future doctors. The model proposed is that of in...Continue Reading

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