( by Emmanuele Pavolini, in Italian healthcare in the face of the Coronavirus crisis ). Therefore, the logic that has guided the transformation of many Western healthcare systems has been: fewer beds for acute cases in hospital and more outpatient/specialist activities on the territory, more residential healthcare facilities (e.g. As already observed by Emmanuele Pavolini (University of Macerata) in a recent article, health services have generally moved towards a strengthening more in the management of chronic conditions than in acute cases, because this is what the analysis of social-healthcare needs in the whole West suggested. In this respect, out of an average of the EU-15 countries of around 35.7% of people over 55, Italy (with over 54%), Germany and France (with 44%) and the United Kingdom, Ireland and Norway (with percentages below 25%) are at the top of this ranking.įinally, the differences in the type of beds in hospital facilities and the number of beds in non-hospital facilities are illustrated to show the trends in the strategies pursued by the different European countries in terms of health service management. Higher shares of people over the age of 55 are evidently associated with a greater rigidity of entry into the domestic labour market. Of interest, as far as doctors are concerned, is the distribution by age group and in particular the proportion of over 55. If we look at the density of nurses per country (always per 1000 citizens), it is possible to distinguish three groups but with different compositions: in particular, we find a lower density, in relation to the density of doctors, for Italy, Spain and Austria, and on the contrary, a relatively higher density for Luxembourg and Finland. A comparison of the density of doctors (without specifying the type of specialisation) among the population (per 1000 citizens) shows how it is possible to identify at least three distinct groups of countries according to their positioning with respect to the European average: countries such as Austria, Lithuania, Germany and Sweden with significantly higher values countries such as Italy, Denmark, France and the Netherlands aligned with the European average value and finally countries such as the United Kingdom, Luxembourg and Poland with a density well below the average value. There are also some more qualitative elements. But it is not only the employment dimension that is asymmetric in a European comparison. Spain and Italy continue to record employment levels in health care below those found in Germany, France and Sweden. There are three observed elements that are proposed as critical factors in a comparative perspective: the share of public funding of health expenditure, health employment relative to demographic trends and the different treatment strategies based on which it has been decided to orient the health system over time. And if indeed the “post Coronavirus” must be different from the “before”, it becomes more and more important to question the way it was before. In addition to understanding how organizational and strategic factors can influence the definition of policies to contain the spread of a pandemic, this dive into health care certainly offers a framework within which the multinationals observed by OpenCorporation tend to move in a diversified way. In continuity with what has already been reported in a previous article on the different relationship between public and private in national health systems in the face of the Covid-19 threat, an attempt will be made here to give a comparative observation point to understand how the capacity to react in the present also depends on divergent structural trends in national health systems in Europe. Davide Dazzi, Ires Emilia-Romagna and OpenCorporation
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