Health system decentralization and recentralization in Italy: Ideas, discourse, and institutions

Terlizzi, Andrea

doi:10.1111/spol.12458

Cited by 7 publications

(4 citation statements)

References 40 publications

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“…Best practices from Italy and Spain highlight the importance of setting quality criteria at the federal level to avoid different levels of spending and quality standards across the country (Ferré et al, 2014;Bernal-Delgado et al, 2018). In essence, the literature shows that governments strive to find a balance between giving regions and municipalities sufficient leeway to meet the local needs for health, while at the same time trying to ensure similar quality standards to prevent inequalities (Fredriksson and Winblad, 2008;Fredriksson, 2012;Bernal-Delgado et al, 2018;Terlizzi, 2019).…”

Section: Contextmentioning

confidence: 99%

Strengthening health system governance in Germany: looking back, planning ahead

Schmitt

Haarmann²,

Shaikh³

2022

HEPL

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Health system governance has been receiving increasing attention in health system research since the 1980s. The contemporary challenges that the German health system is faced with are often closely linked to governance issues. Although Germany has the highest health expenditure as a share of Gross Domestic Product (GDP) in the European Union (EU), the spending on healthcare is out of proportion to the health outcomes of the population. The reason for this lies mainly in the complexity of the German health system which is hard to steer due to several administrative levels in the country and numerous policy actors to whom the decision-making power on healthcare provision is delegated. In this paper, we present the results of focus group discussions on governance and build upon the insights gained through the Neustart project of the Robert Bosch Foundation. Based on an internationally recognised health governance framework from the World Health Organization (WHO), experts who work in, on or for the German health system addressed health governance challenges. They provided evidence-based recommendations for the new legislative period (2021-2025) on transparency, accountability, participation, integrity and capacity of the German health system.

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Section: Contextmentioning

confidence: 99%

Strengthening health system governance in Germany: looking back, planning ahead

Schmitt

Haarmann²,

Shaikh³

2022

HEPL

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“…The rationale behind this decision was to get the organisation of services closer to citizens and to take into account that regional governments are better placed for the organisation of services and the adaption of needs to local situations (Costa-Font and Greer 2016). For example, in Italy, regional governments received important competences in the organisation and financing of health care, in order to make health policy more cost efficient (Terlizzi 2019). In addition to decentralisation and the usage of market elements in health care governance, austerity was a third element of health care reform, especially in some European countries.…”

Section: Similarities Between Countries In Their Development Over Timementioning

confidence: 99%

De Gruyter Handbook of Contemporary Welfare States

2022

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The regulation, financing and provision of health services is one of the main tasks for contemporary welfare states. There is a great amount of scholarship that deals with different aspects of health policymaking. This chapter introduces the reader to this literature in three steps. Firstly, it defines the scope of health policy by distinguishing health care policies, which aim at curing diseases, from public health policies that focus on preventing the outbreak of sickness. Secondly, the chapter presents different typologies of health care systems and discusses how they have evolved over time and how various countries differ regarding their expenditure for health. After that, the paper explores whether the type of health care system has consequences for the capacity of the country to put into place preventative health policies. Thirdly, the chapter introduces readers to the topic of health inequalities and elaborates some of the most recent findings from this literature.

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“…The main reasons for strengthening the central policies in these countries include the inconsistent policies pursued locally in health care services that increase the financial problems, causing geographical inequalities and incompatibility in local and central policies. For these reasons, the necessity of strong central governments for geographical equality and fiscal discipline was emphasized in some countries of Europe, and it was aimed to limit and reduce some powers of regions with strong decentralization in health care through recentralization (Terlizzi, 2018). In 2020, the role of central management in health care and the importance and coordination of the local in the prevention and control of the pandemic was discussed again in the world during the COVID-19 pandemic.…”

Section: D Ec E N Tr a Li Z A T I O N A Nd R E Ce N Tr A L I Za T Io ...mentioning

confidence: 99%

Management of the COVID-19 Health Crisis in the World; An Evaluation on Centralization and Decentralization Practices

BAŞ

Sur

2022

Journal of International Health Sciences and Management

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It has been reported that the tensions, incoordination and incompatibility between the central and local government, and the disconnection in the institutional capacity in the fight against the COVID-19 epidemic, adversely affected the epidemic management. This study was carried out to evaluate the centralization and decentralization practices in the management of the COVID-19 health crisis in the world within the scope of the literature. With the spread of COVID-19 around the world in 2020, most governments have had to take drastic central measures to reduce the spread of the virus. It was emphasized that the measures taken in most countries in the early stages of the epidemic were not taken in coordination with the local units, causing incompatibilities with the local. As of 2021, due to the different experiences of the local effects of the epidemic during the pandemic process, it has been observed that the measures applied in the countries against the epidemic differ according to the local and regions. Ensuring that coordination and harmony between central government and local government/units are important that is explained by the fact that the local effects of the epidemic are different (infection rate, population density, effectiveness of the measures taken, etc.). During the COVID-19 process, it has been observed that countries have different centralization and decentralization practices suitable for their own conditions. It is reported that the simultaneous and complementary coordination of centralization and decentralization in governance in COVID-19 and similar crises will prevent complexity at management levels and positively affect the effective management of the crisis.

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Health system decentralization and recentralization in Italy: Ideas, discourse, and institutions

Cited by 7 publications

References 40 publications

Strengthening health system governance in Germany: looking back, planning ahead

Strengthening health system governance in Germany: looking back, planning ahead

De Gruyter Handbook of Contemporary Welfare States

Management of the COVID-19 Health Crisis in the World; An Evaluation on Centralization and Decentralization Practices

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