Relazione sullo stato sanitario del Paese 2012-2013

[Autom. eng. transl.] "Health is not just a value in itself but is also a driver for growth. Only a healthy population can allow the full economic potential of their country to be reached ”. This is the beginning of the document of the third European Program "Health for Growth" (2014-2020), which, confirming the centrality that health and health have had in the agenda of the European Commission and the governments of the Member States in the last decade, reiterates : the importance of the health sector for the economic and social development of a country, the need to develop innovative and sustainable models of health systems, the importance of focusing attention on prevention. Faced with these demands, the Italian scenario presents a complex picture, both from an economic-financial and a clinical-assistance point of view, which requires considerable effort. From an economic-financial point of view, the system is affected by the crisis, by the contraction of available resources, by stringent public finance constraints with spending cuts and reduced funding, with lower per capita public health spending compared to the main European economies, with a consequent underfunding. From the clinical-assistance point of view, on the demand side, we are witnessing an epidemiological evolution with an aging population and an increase in chronicity; on the supply side, the evolution of medicine and scientific progress increasingly involve the use of advanced health technologies, personalized therapies, advanced drugs. Both of these factors require high investments and in turn have economic repercussions on the system. To better address the outlined context, it is necessary to strengthen the entire system of health governance that is embodied in the cooperation between the Ministry of Health, the Ministry of the Economy and Finance and the Regions. A sustainable health system can be reached, in fact, through the joint action not only of health workers, but of all social and institutional subjects, profit and non-profit, of all the actors that together constitute value for the country system. The actors involved in various capacities in this management will have to follow some key guidelines for the development of the system, such as an optimization of resources and organizational structure, also with a rethinking of the role and integration of public and private, a strengthening of the integrative healthcare, a re-launch of the country's excellences also from the perspective of cross-border care, a constant reinvestment in healthcare of what was obtained from the expenditure review. It is necessary, in particular, that health research be considered as a real investment. It is health research, in fact, that has allowed the conversion from "mortals" to "curable" of some pathologies, guaranteeing an improvement in the outcome of the patients and, at the same time, a strong reduction in the expenses borne by the NHS. It is necessary to select the best research proposals, but also to define the most useful priorities for the management of areas of uncertainty in health interventions. The research must be the lintel on which the NHS must rest and must firstly allow: the rapid transfer of research results to clinical practice and health care; the appropriateness of care and the need for efficient, easily accessible services and this to respect equity; the ethics of research and the ability to communicate "science" to citizens. The Ministry of Health, in compliance with its functions, finances and supports translational research that starts from the laboratory and necessarily reaches the patient. It is a search for the person, not a search for the generic increase of knowledge and, therefore, aimed at satisfying the b