Approccio relazionale e co-creazione di valore in sanità: il caso dell’Assistenza Domiciliare Integrata

Abstract

Aim – The work aims to analyse the National Heath Care Service (NHCS) in order to trace pathways and evolutions that have produced its actual configuration. It highlights limitations of traditional managerial models in health care in order to define new approaches built on the tradition but oriented to a new vision of health service. The aim is to point out some relevant variable for the survival of National Heath Care Service that, in the last years, have been neglected. The purpose is to propose possible actions to focus the attention on the patient in the perspective of relational approach and value co-creation. In order to achieve this aim, an empirical investigation on the satisfaction produced by Integrated Home Care (IHC) in the Salerno province is proposed. Methodology – The work offers an analysis of the National Heath Care Service’ evolution and of the relationship among providers and users in health context. The increasing dissatisfaction in the health context is analysed through a Systematic Literature Review focused on the topics of knowledge management, information asymmetry and cognitive distance. Evidences of literature are analysed using a conceptual framework based on the Viable Systems Approach and on the Service Dominant Logic. Proposed hypothesis are verified trough an empirical investigation on the satisfaction produced by Integrated Home Care in the Salerno province. Specifically, the pathway of research is based on the collection and elaboration of direct data, through a survey, and indirect data, extracted from medical records of patients and analysed with a structural equation model. The investigation aims to measure the satisfaction of patients produced by IHC in the Salerno province and its evolution along the time in order to verify the validity of the hypothesis on which the work is based. Findings – The work offers an interpretation of National Heath Care Service based on the more recent indications of managerial studies. The adoption of a quali-quantitative pathway of research produces some reflections useful to improve the fitting of NHCS to the emerging context’s needs. Empirical evidences show the relevance of relational approach and value co-creation to face the emerging challenges in the health context. Approccio relazionale e co-creazione di valore in sanità: il caso dell’Assistenza Domiciliare Integrata IV Research limitation – Empirical evidences should be further checked with reference to different pathways of National Heath Care Service and observing a more extensive geographical area. Results, therefore, should be considered only the first step of a research pathways oriented to define the future evolution of NHCS. Research and Managerial implication – The study provides a new interpretative perspective of National Heath Care Service’s dynamics. Building on the existent literature and on the adopted conceptual framework, it traces some guidelines to improve efficiency, effectiveness and sustainability in the management of NHCS acting on the Relational Approach and on the value co-creation logic. Originality – The analysis of dissatisfaction in the health context as result of information asymmetry and cognitive distance among provider and user is an advancement of the existent national and international contributions on the topic. The definition of an interpretative model oriented to explain the relationships among providers and users in order to trace possible actions to improve the satisfaction in the health context opens to new possible research pathways. In the end, the empirical investigation on the satisfaction produced by Integrated Home Care represents the first step of an ambitious long pathway of research to which it is linked the evolution of NHCS. Keywords – National Heath Care Service; Integrated Home Care; Relational Approach; Value co-creation; Viable Systems Approach; Service Dominant Logic; Systematic Literature Review; Information Asymmetry; Cognitive Distance; Structural Equation. [edited by Author]