Health: 10 Proposals for Implementing Italy's National Plan for Recovery and Resilience
Ten operational proposals and three enabling factors to successfully implement the Health Mission of the PNRR, Italy's National Plan for Recovery and Resilience, and support the INHS (Italian National Health Service), hard hit by the pandemic that has highlighted both critical issues and room for improvement. This, in brief, is the work of a group of scholars in economics, management and health policies, belonging to six universities: Bocconi University, Milan Polytechnic, Catholic University, University of Turin, University of Rome ''Tor Vergata'' and Scuola Superiore Sant'Anna.
"The PNRR is a document of high vision. It allocates to the INHS important investment resources that must create value within five years. The implementation phase," stresses Francesco Longo of Bocconi University, "is, therefore, just beginning and will last five years: a short time in which it is necessary to define the executive design for each measure, to build regional planning and to implement the policies at the level of the individual local health agencies."
"The interventions planned for the INHS, in addition to improving its effectiveness and efficiency, will play a decisive role in decreasing inequalities in access to the health system," explains Giuseppe Costa, University of Turin. "The success of the PNRR will also be measured by its social impact, not only its economic impact."
The ten proposals will be presented and discussed today from 12 noon in a webinar (in Italian) organized by AIES, Italian Association of Health Economics, open to all INHS stakeholders. Domenico Mantoan, managing Director of AGENAS, will speak at the meeting (here is the link to register and participate https://zoom.us/j/95669697797#success).
"We have developed implementation proposals on the governance and allocation of PNRR funds," explains Federico Spandonaro of the University of Rome 'Tor Vergata', "on the autonomy and constraints for regions and their health agencies, on the development of enabling factors, and on the organizational and operational design of the different lines of intervention of the PNRR."
Specifically, the research team identified a series of operational proposals that will be presented during the webinar. "Through targeted planning and continuous and timely monitoring of outcomes," says Americo Cicchetti, Università Cattolica, "we must be able to achieve the essential health care reform outlined in the PNRR."
The ten priority areas of intervention identified by the research team are:
- strengthening and improving the infrastructure for General Medicine
- strengthening the management of chronic diseases
- rationalizing the territorial outpatient network
- guaranteeing self-sufficiency at home in an integrated form with the welfare system
- standardizing the equipment of intermediate structures between regions
- planning and implementing a change in the skill mix between physicians and health professions
- reforming the public health system by adopting a "one health" approach to health
- Promoting clinical expertise in the small hospital network
- Renewing the infrastructure of large hospitals by changing their logistics and increasing their flexibility and sustainability
- modernizing and making efficient hospitals' technological equipment
"In the path of implementation of the PNRR, the role of the Regions will be fundamental", explains Milena Vainieri, Scuola Superiore Sant'Anna of Pisa, "an investment plan of this magnitude requires a stronger regional expertise in all phases of the life of the projects as envisioned in the Next Generation EU program in supporting the design and implementation of reforms in Member States."
However, the future of the INHS also depends on three strategic enablers: research and innovation, digital transformation, and capacity building. "Success cannot be taken for granted," says Cristina Masella of the Politecnico di Milano. "It requires great cohesion of intent, to be pursued with a strong commitment aimed at creating convergence and institutional collaboration: our work aims precisely at facilitating a continuous collaboration between all parties."
Team members:
Eugenio Anessi Pessina (Università Cattolica), Amelia Compagni (Università Bocconi), Giuseppe Costa (Università di Torino), Americo Cicchetti (Università Cattolica), Giovanni Fattore (Università Bocconi), Francesco Longo (Università Bocconi), Cristina Masella (Politecnico di Milano), Sabina Nuti (Scuola Superiore Sant'Anna), Federico Spandonaro (Università di Roma ''Tor Vergata''), Daniela D'Angela (Università di Roma ''Tor Vergata''), Barbara Polistena (Università di Roma ''Tor Vergata''), Milena Vainieri (Scuola Superiore Sant'Anna), Federico Vola (Scuola Superiore Sant'Anna), Michela Bobini (Università Bocconi), Francesca Meda (Università Bocconi), Claudio Buongiorno Sottoriva (Università Bocconi).