Toward the future community care: a multi-step exploratory study from a service & systems perspective focused on the key role of technology

Abstract

In our fast-changing world, management and marketing acquire a strategic relevance. They become an important reference and support when it comes to making healthcare more effective, efficient, and sustainable. A key contribution in achieving these goals is played by a systems governance and management of healthcare (Pollard, 2016); hence, by the adoption of a systems approach (Golinelli, 2000, 2010; Barile 2000, 2009). Due to an ageing population and the growing number of patients with comorbidity, the number of patients with chronical illnesses (for which there may not be a cure) is growing. This situation highlights the need to define governance policies capable of ensuring the sustainable development of the economic and social system through appropriate forms of organization. In this problematic context, a need to understand and interpret the complexity of service systems and social phenomena using general schemes of interpretation, arises. Essentially, the complex goal is to balance the effectiveness, efficiency and sustainability of service in the governance of the healthcare system (Saviano, Bassano, & Calabrese, 2010). Accordingly, this study aims to investigate the evolutionary trend of change that the Italian Healthcare System is facing now in order to make healthcare service more effective, efficient and sustainable using the lens of systems thinking as a valid interpretative support of complex phenomena. On the basis of this premise and considering the widely agreed need of increasing community care, especially experienced during the COVID-19 pandemic, more specifically, this work aims to investigate the conditions of the effectiveness, efficiency, sustainability, and also safety, of healthcare services while shifting from the hospital setting to community and home care. This shift is rich of implications and, although hospital care is in actual fact the highest level of assistance in both structural and organizational terms, it may result much more complex to effectively, efficiently and sustainably organize care at a community and home care, given the need of integrating many diverse systems components. [...] [edited by Author]