[Governance in a project addressing care of disabled elderly persons within the regional healthcare system of Tuscany, Italy]

Gualtiero Ricciardi, Gianfranco Damiani, Anna Acampora, Claudio Pedace, Antonella Rosa, Paolo Francesconi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Population aging and the concurrent increase of age-related chronic degenerative diseases and disability are associated with an increased proportion of elderly persons who are dependent in activities of daily living (ADL). ADL-dependent persons need continuous and long-term health and social care according to the "taking charge" rationale, in order to warrant access and continuity of care. A healthcare system needs to respond to the long-term and complex needs, such as those of disabled elderly people, by providing appropriate health and social care services in Primary Care. A Primary Health Care system is organized according to two governance levels have distinct aims but are closely inter-dependent in their operational mechanisms. The system governance is accountable for the community and individual health protection while the delivery governance is accountable for the provision of services in accordance with appropriateness, safety and economic criteria. Delivery governance can be considered "integrated governance" as a synergy exists between two decision-making systems guiding provider choices, which are corporate governance and clinical governance. The aim of this study was to analyse the abovementioned governance levels within the healthcare system in Tuscany (Italy) referring to long-term residential care for disabled elderly people. The case of excessive accesses to emergency departments from different types of Nursing Homes (NH) is used as an example to analyse different levels of responsibility involved in the management of a critical phenomenon. Suggestions for improvement in the different levels of governance for disabled elderly people are provided, in order to support institutional programming activities.
Titolo tradotto del contributo[Autom. eng. transl.] [Governance in a project addressing care of disabled elderly persons within the regional healthcare system of Tuscany, Italy]
Lingua originaleItalian
pagine (da-a)351-372
Numero di pagine22
RivistaIGIENE E SANITÀ PUBBLICA
Volume73
Stato di pubblicazionePubblicato - 2017

Keywords

  • care of disabled elderly persons

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