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OECD Reviews of Health Care Quality: Italy 2014

Raising Standards

image of OECD Reviews of Health Care Quality: Italy 2014

This report reviews the quality of health care in Italy, seeks to highlight best practices, and provides a series of targeted assessments and recommendations for further improvements to quality of care. Italy’s indicators of health system outcomes, quality and efficiency are uniformly impressive. Life expectancy is the fifth highest in the OECD. Avoidable admission rates are amongst the very best in the OECD, and case-fatality after stroke or heart attack are also well below OECD averages. These figures, however, mask profound regional differences. Five times as many children in Sicily are admitted to hospital with an asthma attack than in Tuscany, for example. Despite this, quality improvement and service redesign have taken a back-seat as the fiscal crisis has hit. Fiscal consolidation has become an over-riding priority, even as health needs rapidly evolve. Italy must urgently prioritise quality of its health care services alongside fiscal sustainability. Regional differences must be lessened, in part by giving central authorities a greater role in supporting regional monitoring of local performance. Proactive, coordinated care for people with complex needs must be delivered by a strengthened primary care sector. Fundamental to each of these steps will be ensuring that the knowledge and skills of the health care workforce are best matched to needs.

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Medical education and training in Italy

This chapter considers how effective Italy’s medical education system, and in particular the continuing medical education system, are for securing a high quality workforce of health professionals. The relatively good results that Italy’s health system is delivering suggest that the medical workforce is, in general, providing care of a high quality. Looking to secure this high performance for the decades to come, and push back against any regional disparities in quality and outcomes, Italy has also been taking important steps towards ensuring nationally cohesive workforce training programmes. However, going forward, good medical education and nationally standardised continuing medical education may not be enough to secure a high quality, high performing medical workforce. There is scope to look to the scientific literature, and the experiences of other OECD countries, to try to maximise the impact of medical education, from the undergraduate level and beyond. This chapter suggests that Italy could promote workforce quality when selecting future medical professionals prior to undergraduate education, and ways to improve the quality of undergraduate medical teaching. There are also opportunities to maximise the positive impact of Italy’s existing continuing medical education programme, and this chapter suggests that there is a need for Italy to eventually develop more modern models of workforce quality insurance, including a move to continuing professional development, and using data to encourage health professionals to reflect on their practice. 3

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