Guida alla Nutrizione Infantile (Italian Edition)
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In examining these areas, this report examines the quality of care currently provided, seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. The Italian Servizio Sanitario Nazionale or National Health Service, SSN was established in to grant universal access to a uniform level of care throughout Italy, free at the point of use, financed by general taxation.
The Ministry of Health fulfils the function of the overall steward of the health system and defines the livelli essenziali di assistenza or essential level of care, LEA to be delivered across the country. In recent years, however, many regional health budgets ran into substantial deficit, leading to central authorities to imposing Piani di Rientro Recovery Plans on ten of them, of which eight are on-going. These plans signalled the introduction of a dominant new player in national health care policy — the Ministry of Finance.
Although the Ministry of Health maintained its role in ensuring that essential levels of care were provided at regional level, the Ministry of Finance became actively involved in designing and approving health care delivery. To a large extent, then, the focus of this abrupt resumption of central control was financial and quality of care risked becoming secondary. Italy is facing, therefore, two major challenges.
The first is to ensure that ongoing efforts to contain health system spending do not subsume health care quality as a fundamental governance principle. A more consolidated and ambitious approach to quality monitoring and improvement at a system level is needed. Over the past decade, a range of quality-related activities have been developed, with varying depth and scope, and with little co-ordination across these approaches by central agencies.
These divergent approaches must now be consolidated. At the same time, other key quality strategies are poorly developed or absent. Requirements for recertification and for professional development are not established and payment systems do not systematically reward improvements in clinical care and patient outcomes. These deficiencies must be addressed to ensure that Italian health care quality architecture is comparable to the best seen in OECD health systems.
Primary health care in Italy performs well — rates of avoidable hospitalisation are amongst the lowest in the OECD. Italy faces, however, a growing ageing population and a rising burden of chronic conditions, which are likely to result in higher health care costs and place further pressures on the primary care sector. Whilst the management of chronic conditions requires a co-ordinated patient-centered response from a wide range of health professionals, the Italian health care system has traditionally been characterised by a high level of fragmentation and a lack of care coordination.
Italy has made considerable efforts to experiment with new models of community care services such as community care networks and community hospitals that aim at achieving greater co-ordination and integration of care. Although the expansion of community care services is an appropriate policy response to meet the growing demand for health care, they are still unevenly distributed across Italian regions.
Greater guidance and support from national authorities is needed to ensure a more consistent approach. Efforts are needed to increase transparency, develop performance measurement and strengthen accountability in the sector.
The development of a set of standards around the processes and outcomes of primary care, the setting-up of smarter payment system, and increase the involvement of primary care physicians in preventive activities are options that Italy should consider pursuing if it is to meet the challenge of an increasing burden of long-term conditions. The medical workforce delivers, in general, care of a high quality. Looking to secure this high performance for the decades to come, and push back against any regional disparities in quality and outcomes, Italy has also been taking important steps towards ensuring nationally cohesive workforce training programmes.
However, going forward, good medical education and nationally standardised continuing medical education may not be enough to secure a high quality, high performing medical workforce. There is scope to look to the scientific literature, and the experiences of other OECD countries, to try to maximise the impact of medical education, from the undergraduate level and beyond. This chapter suggests ways that Italy could promote workforce quality when selecting future medical professionals prior to undergraduate education, and ways to improve the quality of undergraduate medical teaching.
GDP per capita varies more than two-fold and unemployment rates more than four-fold. Italian health care services, being fully regionalised, reflect this heterogeneity. Italy has established a number of mechanisms to try and ensure an evenness of approach to quality measurement and improvement. These include activities to ensure dialogue between national and regional authorities as well as professionally led initiatives to measure quality consistently.
Key priorities are to develop a more consistent approach to using information to manage performance and strengthen local accountability. Ensuring that regional resource allocation has a focus on quality, and is linked to incentives for quality improvement, will also be important. Actions that strengthen the regional approach to health care governance and delivery in Italy are also needed. Reframing governance as a whole, such that quality improvement is emphasised as much as financial control, is also necessary.
Promoting the quality and appropriateness of health care. Standard healthcare costs and requirements……………………… 15 2. Reorganization of primary and hospital care………………………. Quality of health services and humanization of c………………… This is consistent with what is stated in the conclusions of the European Council… 2.
WHO Collaborating Centre (English version)
The National Health Plan…………………………………………………………… 19 2. Initiatives on SSN staff……………………………………………………………… The purpose of SiVeAS is to verify the compliance with the criteria for the appropriateness and quality of health care services, consistent with the Essential Levels of Care, and the efficiency criteria in the use of production factors, in accordance with the provided funding.
Int J Public Health. Epub Feb We ranked risk factors using a score based on the product of six criteria: deaths attributable to risk factors; prevalence of risk factors; risk factor prevalence trend; disparity based on the ratio of risk factor prevalence between low and high education attainment; level of intervention effectiveness; and cost of the intervention. RESULTS: We identified seven priorities: physical inactivity; cigarette smoking current smoking ; ever told had hypertension; not having blood pressure screening; ever told had high cholesterol; alcohol heavy drinking ; not eating five fruits and vegetables a day; and not having a fecal occult blood test.
The research activity focuses on:. Home care is an important way of providing medical, rehabilitative, nursing, rehabilitation, care facilities to people who, for reasons related to disability or other limitations of their autonomy, are unable to go to hospitals or outpatient facilities to undergo the cures they need.
Health and social workers of the Local Health Units provide these treatments.
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The quality of home care is closely linked to the efficiency of the organization of the territorial districts, which must coordinate the takeover. The results of these researches highlighted that Italians like to be treated, assisted and rehabilitated at home. The objective of the research is to identify and evaluate the territorial assistance models emerging from the ongoing experiments in Italy, to define the network models that can be realized in the medium to short term that meet the needs of the territory; to evaluate open issues: association in jagged territories, cities and rural areas, contracts to be concluded with Regional Health Systems, ways of allocating resources and reimbursement of benefits; to evaluate the critical areas of the processes.
The data collected from this research will be organized in a report that will be available on the Cure at Istud Foundation House, and presented during a scheduled event by the end of November. The Observatory is a consultative technical and scientific support to the development of national policies on disability, mainly aimed to:.
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Studi, esperienze, strumenti di lavoro. These actions can help prevent serious risks of different kinds such as congenital malformations, low birth weight, SIDS, infections, road trauma, obesity, cognitive and relational difficulties. Ann Ig. One of the objectives of this role is also to take a major part in the support of immunization coverage of infants, especially in light of the sospension of required immunizations in the Veneto Region. For this reason it is necessary to open dialogue on immunizations together with pediatricians and family physicians.
In addition, training of these professional figures, together with healtcare operators who work in the immunization clinics, has allowed the formation and standardization of the network, as the persons who attend the immunization clinics are no longer passive users but persons who require information exchange in order to make an informed choice about immunizations for their children. This paper reports the results of a survey on vaccination coverage among children born in January and residing at the beginning of the study March in the city of Naples, Italy.
The percentages vaccinated, at various times from birth, with oral polio vaccine OPV , have been compared with those found in a similar survey conducted at the end of regarding the cohort of children born in June Similar results were found with the second doses. A significant association has been found between socioeconomic status and coverage level.
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Epub Jan 4. Despite the launch of a WHO European Region strategic plan for eliminating measles and rubella and preventing congenital rubella CR infection, measles and rubella are still circulating in Europe. Increased transmission and outbreaks of measles in Europe were still observed in In Italy, the objectives of the National Plan for measles elimination have not yet been achieved.
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Experiences at regional level, like in Tuscany, have shown promising results in order to create an integrated surveillance system between regional and local health authorities, university and laboratory and in the future, to validate elimination. Moreover, the evaluation of all preventive activities performed in Tuscany during the last decade, immunization coverage data, sero-epidemiological population profile and incidence of measles and rubella cases has highlighted critical points which should be improved and good practices already implemented which should be maintained in the future in order to reach the new goals.
Two measles outbreaks, occurred in Lazio region during , were investigated to identify sources of infection, transmission routes, and assess operational implications for elimination of the disease. METHODS: Data were obtained from several sources, the routine infectious diseases surveillance system, field epidemiological investigations, and molecular genotyping of virus by the national reference laboratory. Serotype B3 was responsible for the second outbreak which started in a secondary school.
The successful elimination of measles will require additional efforts to immunize low vaccine coverage population groups, including hard-to-reach individuals, adolescents, and young adults. An enhanced surveillance systems, which includes viral genotyping to document chains of transmission, is an essential tool for evaluating strategy to control and eliminate measles.
In the National Health Program , the Italian Ministry of Health introduced a plan to improve maternal and child health. Thus, in 25 LHU, two population-based follow-up surveys were conducted in and in before and after the programme implementation. Although a private and medicalized maternal assistance model persists, the results show a general improvement in pre- and post-natal care indicators as attendance to antenatal classes, information received by the mothers during and after pregnancy, counselling in puerperium offered by the public family care centres, and breastfeeding.
http://triusenterprises.com/what-is-the-best-cell-phone-locate-alcatel-1x.php The assistance by public family care centres and the attendance to antenatal classes have a positive effect on natal care indicators. It is worthy empowering these services and giving a suitable training to the involved health personnel. It aims to estimate the prevalence of overweight and obesity among primary schoolchildren and to examine the behavioral factors associated. The methodology has been validated in collaboration with INRAN and some communication tools developed with the project Pinc. This surveillance system is a valuable tool to monitor the evolution of the obesity and may help to promote public health interventions.
Contraceptive counselling in the pre and post-natal period may be important for the use of postpartum contraception and prevention of induced abortion.
This paper evaluates the use of postpartum contraceptives and the factors associated with it in a sample of Italian and immigrant women. Materials and methods. Descriptive analyses and logistic regression models for complex survey data were used. This study supports the notion that health professionals should take every opportunity during pregnancy, childbirth and puerperium to provide information and counselling to improve knowledge and awareness of contraception.
Breastfeeding is widely recommended. Updated data are needed to assess its prevalence and the effectiveness of interventions. Breastfeeding practices in Italy need to be promoted and monitored with updated and standard data The objective of this study is to provide estimates of the prevalence of breastfeeding and exclusively breastfeeding and to identify factors that may be modified to improve them. Two population-based follow-up surveys were conducted to evaluate the quality of maternal care in 25 Local Health Units LHUs in Italy during Women were interviewed soon after giving birth and after 3, 6 and 12 months.
Breastfeeding prevalences were estimated. A logistic regression model was used to investigate factors associated with exclusive breastfeeding at 3 months. Breastfeeding and exclusively breastfeeding prevalence estimates were At 12 months, In Italy many mothers do not comply with breastfeeding recommendations. The promotion and support of breastfeeding is still necessary in Italy and still needs to be monitored with representative data.