ABSTRACT
During COVID-19 pandemic, health and social condition of frail elderly got worse at worldwide level. This aggravation was due both to isolation and higher mortality rate for COVID-19, influenced by the widespread condition of comorbidity in this segment of population. The progressive change of needs in this target weren't matched with a prompt and adequate response, which could guarantee the taking charge of frail elderly. Personal budget is a tool for integrating public health, social assistance and family efforts on the international scene. In the Italian context, it is emerging as means to program and coordinate economic and professional, institutional, and personal resources, finalising them to provide a personalised pathway. Research aims to value the contribution of personal budget association to effectiveness and efficacy of personalised pathway for frail elderlies in early supported discharges. A research-intervention approach was done. Personal budget was applied to a significant sample of cases of personalised pathways for frail elderly in supported discharge in the Local Health District of Teramo. The study compared used resources and obtained health outcomes between the sample and a control group. The application of the personal budget permits the immediate maximisation of resources use and the quantification of the deviation between the available and the needed resources for provision of personalised pathway. Moreover, this tool supported the planning of services, the integration of health and social actions, the monitoring of adherence to planned programmes and the application of corrective mechanisms, if these are necessary, improving the health outcomes. Personal budget contributes to increase the integrated and continued taking charge of frail elderly in supported discharges in the short-medium term. Globally, this tool could be an organisational and economic answer for responding in a sustainable way to international increasing of life expectancy. Key messages • Personal budget manages and controls both health and social activities and resources. • Personal budget supports the establishment of an integrated and continuous taking charge system of the frail elderly.
ABSTRACT
Globally, the reforms of healthcare systems aim to bring back the patient at the centre of these organisations after the issues related to the COVID-19 outbreak. The patient returns to be fully considered, as an individual whose must be protected physical and psychological health as well as social well-being. Humanization of care is returning to the foreground. For centuries, art has been used throughout Europe in the health context for its power to support patients in their disease. Today, this approach can be rediscovered in historical hospitals, where tradition, art and assistance coexist. This study aims to investigate the interest for the development of projects for the humanization of care exploiting the artistic heritage of the historical hospitals owned by Health Authorities. The cross-case analysis was chosen as study design. The case studies are the historical hospitals in the city centre of Venice, Florence, and Rome. The evaluation of the proposal was carried out through semi-structured interviews with the general managers of the Health Authorities, the medical directors of the selected hospitals and the delegates for the protection and promotion of cultural heritage. The results were analysed using a qualitative model (coding). All respondents welcomed the proposal to launch projects for the humanization of care that foresee the use of the artistic heritage of the historical hospitals to involve patients in the field of health care. Interviewees expressed the desire to invest human and structural resources in the development of these projects. Moreover, directors suggest choosing a specific target with which to start the experimentation and to dispense a specific training to future engaged social and health personnel. The implementation of projects for the humanization of care using the artistic heritage of historical hospitals can be replicated worldwide where healthcare institutions have a cultural wealth to be handed down, shared and valued. Key messages • In the post COVID-19 era, it is strategic to exploit artistic heritage owned by the Health Authority for the positive impact in the patient’s experience. • Artistic heritage claims its role as a health service for supporting patients, caregivers and also health workforce.
ABSTRACT
The Public-Private Partnership (PPP) phenomenon is enjoying a global revival of popularity, despite much uncertainty on the definitions of partnership and the colorful experience gained from their practical application. While they are being rapidly embraced not only in the free market and developed economies but also in developing countries, uncertainties persist as to what exactly is innovative-or fruitful-about PPP. In developed countries, the evolution of PPP to "state after welfare", reflects a shared experience in systems theory that has evolved substantially, particularly in Western European economies. This article analyzes the dynamics of implementation of PPP in the healthcare sector considered as opportunities for countries in transition, enhancing the case of Albania considered as a typical Balkan transition country of the post-Soviet era. When the course of two decades has almost been completed the changes that countries in transition are facing are significant and have transformed the way of the economic environment. In transitioning or developing economies, despite the potential for PPP arrangements to finance and develop public projects, the use of PPPs has been slowand limited (Yang et al., Public Administration Review 73:301-310, 2013). Currently, Albania boasts a portfolio of more than 222 PPP, 186 in energy with the rest in transport, health, environment, and agriculture. As in the focus of the article, there is an overview of the four PPP in the healthcare sector considering one out of four as the case study based on the importance as well as the changes and needs during Covid-19. The article will highlight a need to adopt a long-term strategy in the field of healthcare aswell as applicable standards for the monitoring of the implementation procedures. The healthcare sector in a typical Balkanic transition country, that aspires for European Union membership, such as Albania, was considered as a case study in the research because in the healthcare were introduced reforms aim to improve the public health system, the quality of care provided, and to reduce out-of-pocket healthcare expenses and the application of PPP in this sector were considered as part of this reforms and their success. The case study is based on the data collected from the analysis of the contracts signed between the parties, different reports, interviews and the documentation collection with regard to the management of this contract are going to be used. During the Pandemic moment, the implementation of these contracts became even more important for a country facing a global emergency regarding health care when these contracts were seen as a way of innovation in the management of public services.