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Ben RHM II - LZG.NRW

Ben RHM II - LZG.NRW

Benchmarking Regional Health Management II (Ben RHM II) ___________________________________________________________________________________________________________________________________________________________________ 5.3.9.2 Italy (Sicily) 58 1) Prevention and strategy programmes are defined and issued at national level by the Health Ministry through agreements with the scientific associations and the Centro Na- zionale per la Prevenzione e il Controllo delle Malattie (CCM – Italy's National Centre for Disease Prevention and Control). The Prevention Department is in charge of health co-ordination, supervision and intervention and also of the information for citizens and health personnel. With the passing of Law 138, 2004 ("Urgent interventions for confronting public-health hazards"), CCM was established at the Ministry of Health. The main objective of CCM is that of active prevention through both the promotion of healthy life styles and screening and of confronting a variety of health emergencies. CCM has been created as a network of existing institutions and experts: the activities of CCM are coordinated with those of the Regional Health Authorities and with national institutions and organisations (ISS – Italy's National Health Institute; University research centres; Associations involved in healthcare and in public and private research). Following the Agreement of March 23 rd , 2005 (State-Regions Conference) Regional Authorities have to bring into action National Prevention Plan objectives, intended to improve the effectiveness and the efficacy of prevention programmes at regional level and to lower National Health Service costs. CCM will coordinate with Regional Health Authorities for surveillance and active prevention programmes. The main areas of concern of the National Prevention Plan, which will last three years, also include: vaccination plan, prevention of complications in diabetes and cancer screening. The National Health Plan has issued the directives for the prevention and care of diabetes. The National Diabetes Project was created in accordance with the lines of the NHP on the basis of information given by the Scientific and the ill Patients Associations and it is addressed to promote a correct lifestyle and to give adequate information on the pathology and on reference centres for screening and care. In 2004, an epidemiological study was carried out in all Italian Regions in order to evaluate the level of services quality addressed to the patients affected with diabetes. The QUADRI project, realised with the coordination of the National Health Institute, had as objective to evaluate the quality of perceived assistance, the regularity of the clinical and biological follow-up and the adequacy of the proposed information to im- 58 Author: CEFPAS – Centre for Training and Research in Public Health, Caltanissetta. - 218 -

Benchmarking Regional Health Management II (Ben RHM II) ___________________________________________________________________________________________________________________________________________________________________ prove the quality of life and to avoid the most frequent complications. The study gives useful information for the elaboration of more efficient and effective strategies of the disease management. 2) The Sicilian Region has a “Special Statute”. The Sicilian Regional Assembly issues and adopts national laws. The Ministry of Health is a government authority. It is the institu- tional body that addresses, coordinates and gives the programmatic lines in the field of population health through decrees and regional laws. The Regional Health Plan adopts the national directives, and explains the organisational strategies and the objectives to be achieved. For diabetes, specific Regional directives have been issued “Guidelines for the prevention of acute and chronic complications linked to the diabetic illness and for the organisation of the structures of diabetology in Sicily” (Law 30 April 2002). 3) Primary Care for the diabetic patient is provided by GPs; specialised assistance is offered by the Diabetic Centres created in the Health Districts (Local Health Departments) and in the Public Hospitals. The screening programmes, care and surveillance are then carried out in an integrated way by GPs, Public Hospitals and Diabetic. This kind of organisational structure is recommended in the recent National Prevention Plan 2005/2007 of CCM that stresses the effectiveness of the integration programmes of active prevention and disease management. A regional Health System Disease Management Project is going to start next year. The objectives of the programme are the following: � To implement a governance system for diabetes allowing the promotion and the monitoring of the quality of the assistance, the monitoring of the effectiveness, efficacy and clinical/organisational appropriateness. � To promote the integration and the continuity of the assistance. � To improve the equity and the accessibility of health services. � To implement a benchmarking process among the Health Organisations on the clinical/organisational indicators related to the treatment of chronic diseases. - 219 -

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Part II