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Italy (Bolzano) / Social care / Policy indication for the integrated health, social-health and welfare. Lombardy Region

IT30_ITC4__Policy indication for the integrated health, social-health and welfare. Lombardy Region_2014

Name of the country Italy (Bolzano)
Sector Social care
Name of the document (original) Indicazioni di policy per l'integrazione sanitaria, socio-sanitaria ed assistenziale. Regione Lombardia
Name of the document (English) Policy indication for the integrated health, social-health and welfare. Lombardy Region
Administrative level Regional/Lombardy
Type of the document Report
Year of adoption 2014
Foreseen duration 2014
Sector Social care
Territorial unit (NUTS/LAU) ITC4
Authority √Čupolis Lombardia
Availability in English No
Legally binding Non-binding
SGI coverage SSGI
Integration as a concept Yes
Integration elements
Adm. levels
Fin. sources
Description Heterogeneity of the institutional actors involved utilizing also various financial instruments Fund for Social Policies Strengthen, simplify and coordinating the planning of social services at all levels Coordination between national, regional and corporate programming Relative autonomy of regional and business areas public resources for the health and social sector in 2009 amounted to 49 billion euors net social expenditure for social services of the municipalities the source of funding national, local
Major objectives Informative instrument on
Integration of social health
Policies implemented
Recommendations for synergies between institutional actors
Short Summary The policy paper analyzes the evolution of the demand for care, closely linked to the aging population and a life marked by elderly as well as the presence of
more diseases and a higher incidence of chronic and degenerative diseases.
The analysis focuses on the context of the Lombardy Region, placing in the national dimension to the legal framework, institutional and financial performance of the social and health policies. The comparison between Lombardy and the national context allows to highlight both the constraints and the autonomous development of the organizational Lombard model, which stands out on a national scale for the adoption of the separation between clients and production.
An illustrative analysis of the policies is developed for integrating social care through an inter-regional comparison, which focused on policies and
interventions for Integrated Homes (ADI Assistance). The choice of this area is dictated by the intention to make a comparison between different regions comparable (Toscana, Veneto, Emilia Romagna) on the basis of the model implemented and the results achieved, within the same national legal framework and in response to express the same demand - fragility and chronicity.
Finally, the paper highlights the difference between direct and indirect management model discussing it through the results achieved, the economic and organizational resources used, the capacity of covering the demand and the impact of these services over regional articulation of social and health systems. The observation is based on data available concerning the existing models.
The National legislation explicitly defines' "assistance", and not integration, of social care as a "set of activities to satisfy, with integrated care pathways, the person's health needs that require a unified healthcare services and activities of social protection in the long run, the continuity between the actions of care and rehabilitation of those "
This means that most of the resources are not subject to integrated planning, but coexist allocative decision and parallel processes between the different actors that are further fragmenting the system.
In general, therefore, a close interdependence between the institutional arrangements of planning levels and flows of funding can be observed in the sector of health and social policies, which returns the composite picture of the sector together with the difficulties to define what is the integration of care.
Centralised/decentralised centralised-decentralised
Governance model
Public services
Public-private partnership
Comments private bodies
Measures Structural and funtional measures
Formation of social care employees
Functional integration
Strenghten centralised information system
Strengthen the role of primary care and general medicine
Structure between hospital and domicile
Simplify programming and scheduling
Strengthen strategic commissioning (programming, negotiation, purchase,
monitoring and control)
Reorganise tariffs
Type of finance
No sources available.
Sources of finance
Stakeholders' list
Federal/national SSN (National Health Service) USL (The local health unity) INPS (National Institute of Social Security)
Regional Regional Health Fund
Local Municipalities Local Social Care Agency (ASL)
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