In the context of the legal changes that have affected the Italian society over the last two dec-ades, this article investigates the figure of amministratore di sostegno, introduced by law in 2004, as care responsible for people in condition of fragility. At the macro level, the analysis delves into the evolution and characteristics of such legal change. At the micro-level, it focuses on the case study of the Marche region, in relation to people with disabilities in the case of ab-sence of parents or family members. The data relating to the transformation of the law into liv-ing practice show several critical aspects: in fact, the analysis highlights that the flexibility, characterizing Law n. 6 of 2004, provides wide space for delegating to social services and civil society the responsibility for caring of fragile people. Such result seems to confirm the process of de-juridification of society. This trend poses the risk of increasing inequalities at local level, within the Italian residual and familistic welfare system, characterized by already severe re-gional differences.
La pandemia ha contribuito ad accelerare in Italia l'uso della "telemedicina". Focalizzandosi sull'analisi delle Linee Guida per la Telemedicina nell'assistenza domiciliare (2022), questo lavoro mette in luce come il modello proposto di cura sancisce l'ambiente di azione del medico lontano dal paziente non solo nello spa-zio, ma anche a volte nel tempo; mentre mantiene a fianco del paziente la semi-professione degli infermieri e delinea spazi potenzialmente di grande innovazio-ne anche per la figura dell'Operatore Socio Sanitario (OSS), anche se ufficial-mente non è mai menzionata. La telemedicina, con le sue innovazioni nei luoghi e nei tempi delle pratiche di cura, delinea una nuova spazializzazione della malat-tia con delle caratteristiche specifiche e delle implicazioni sostanziali per le pro-fessioni sanitarie sia per quanto attiene le loro singole identità che le relazioni tra loro.
The integration of welfare services in activation policies has been one of the common answers to welfare challenges in EU member states over the last two decades. The process has been interwoven with the rescaling both downwards and upwards of welfare regulative authorities. The article discusses the role of integrated services in activation policies in relation to the centralisation and decentralisation of welfare policies in a comparative perspective of different EU welfare regimes and highlights the role of local institutional milieus in shaping path-dependent modes of governance in integrated services.
Comparative studies on health systems in Europe show growing convergence in terms of general characteristics, while insufficient attention is paid to the overall range of varying welfare policies within which the health systems operate. By developing the theoretical model of health systems, this work puts forward the construction of an analytical approach able to contextualise health policies within the relative welfare systems. It proposes health regimes as an analytical category, defined on the basis of the different roles played by the actors called on to respond to health needs: the state, the market, the services sector and the family. Through a comparative study of a number of indicators, it outlines the four main ideal types of health regime in Europe. The attention on the contexts in which health systems operate makes it possible to recognise and valorise the contribution that the various actors make in responding to health needs, thus promoting a more complete vision for the analysis of health policies in Europe.
COVID-19 has highlighted strengths and weaknesses in healthcare systems all over the word. Despite the differences in primary care models in Europe, this study investigates the state-of-the-art of general practitioners (GPs) before the COVID-19 pandemic spread as a result of the reform process of the previous two decades. The GPs numbers over 100,000 inhabitants has been considered as a proxy of public health investment in GPs. Is the number of GPs increased or decreased in the last 20 years of reform processes in European countries? The main hypothesis is that European healthcare systems would have increased the number of GPs coherently with WHO recommendations. Comparative data on the number of GPs per 100,000 inhabitants in 21 European countries are investigated between 1995 and 2014 (the last available data). Data show that the number of family doctors over 100,000 inhabitants in European countries has increased over the last 20 years, except for Italy, where it has strongly reduced. Primary care has had a crucial role in managing the pandemic. Results of this study suggest that a country such as Italy, which has not invested in family doctors in the last two decades, would have been less equipped to manage the COVID-19 pandemic.
Several grassroots initiatives in the last two decades have shown the need for different food practices that should be locally based and founded on ethical goals of social and environmental justice. Among the many “alternative food networks”, the Community Supported Agriculture model is particularly significant and interesting. By redefining meanings and social norms around food practices, this model actualizes significant processes of food re-socialization and re-territorialization. Focusing on Italy, this study aims to contribute to the understanding of the potential of this model. It does so through two investigations carried out in 2019 and 2020, aimed at analyzing, respectively, structural and organizational aspects of CSAs and the features of resilience shown by these initiatives during the first COVID-19 pandemic lockdown. On the whole, the two surveys give us the image of a radically innovative experience, potentially capable of deeply redefining production and consumption practices, being rooted in socially-shared knowledge, motivations, willingness, commitment and sense of community. In addition to being characterized by a determination to pursue sustainability and equity goals, the model shows a remarkable character of resilience thanks to the original arrangements that the common value basis and the strong sense of interdependence and solidarity of its members can provide.
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