Il management della salute di prossimità nelle aree rurali: sfide tra visione strategica e attuazione organizzativa

Privileging an approach to critically questioning the strategic, organizational and managerial paradigms implied by the challenges of proximity, avoiding outlining standard operating models and tools that, if not properly declined with respect to the reference contexts, are harbingers of risks of reducing the complexity of the current phenomena, the volume focuses on the design and development of neighborhood health services in rural areas. The decision to deepen the reflections relating to rural areas is justified by a twofold order of considerations: on the one hand, the needs to protect health equity require us to consider these contexts, so widespread from a geographical point of view in our country; on the other hand, peculiarities and specific needs of rural contexts (for example in terms of topography of territories, access and distance from the infrastructures of urban networks, demographic, economic and social characteristics of the population) determine the need for decline the implementing interpretation of proximity health management in line with these elements. \ r\ n The volume summarizes the main learning that emerged from field research carried out in 9 territorial health companies of the NHS, with particular reference to:\ r\ n − delimitation of the adopted concept of rural areas;\ r\ n − need to know and recognize the characteristics that distinguish rural areas belonging to a given business context;\ r\n− strategic elements founding a participatory and responsible vision\ r\ n of generating local health in rural areas;\ r\ n − points of attention in designing and implementing solutions organizational\ r\nwith widespread, integrated and flexible responsibility to ensure proximity health in rural settings;\ r\n− main strategic determinants aimed at supporting the development of neighborhood health in the contexts under investigation;\ r\n− institutional determinants that can enable or facilitate the foreshadowing and implementation of business innovations aimed at promoting\ r\ n effective and equitable proximity health in rural areas.