Modelli regionali di partecipazione in sanità. Uno studio comparativo

ABSTRACT

One of the main dynamics of change in the Italian welfare system since the 1970s has been the restructuring of decision-making processes to encourage participation. Today, the new millennium presents evidence of the growing protagonism of the public service authorities in this process. This leading role heralds ambivalent outcomes;although it expresses an attempt to retain the public service’s role as guarantor of fundamental rights, it also lends itself to processes of de-accountability of the same public body. Twenty years after the reform of Title V of the Italian Constitution, this article examines and compares the institutional representations of the role of citizens-users/patients in five regional health systems in Italy. Our study, conducted using the Delphi technique, identified the instruments currently applied and the impact of the 2020/2021 Covid pandemic on the regional systems. The results highlight some interesting experiments in the direction of overcoming the traditional “democratic deficit” of the health system;even if the organizational, communicative, cultural and training challenges of “competent” citizens and communities remain open and further accentuated after the Covid-19 pandemic. Copyright © FrancoAngeli