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FrancoAngeli Journals

Saggi

No. 134 (2025)

Territorial Healthcare Performance’s Measurement and Evaluation: Current State and Future Perspectives

DOI
https://doi.org/10.3280/mesa2025-134oa22028
Submitted
febbraio 10, 2026
Published
2026-04-24

Abstract

The National Recovery and Resilience Plan (NRRP), within the framework of the “Health Mission,” has introduced a broad set of interventions aimed at shaping a new organizational model for the National Health Service (NHS), grounded in the principle of healthcare that is more close to and responsive to people’s needs. These interventions have focused, on the one hand, on strengthening investments in the innovation of healthcare technological infrastructure, with particular emphasis on the promotion and widespread
adoption of telemedicine; on the other hand, on enhancing the provision of home-based care services. In this context, the Reform of Territorial Healthcare, enacted through Ministerial Decree No. 77 of 23 May 2022, assumes particular relevance, as it puts forward new organizational and care delivery models intended to ensure healthcare that is more accessible, integrated, and person-centred.
Against the backdrop of the profound reforms affecting primary care, this study presents a systematic review of the literature on the measurement and evaluation of territorial healthcare performance. Healthcare performance is conceptualised through a multidimensional lens, as the traditional Donabedian framework – based on the tripartite distinction between structure, process, and outcomes – while constituting a well-established analytical reference, proves insufficient to fully capture the complexity of contemporary territorial healthcare.
This limitation calls for the incorporation of cross-cutting dimensions such as accessibility, continuity of care, equity, and quality. Accordingly, the analysis seeks to provide a structured literature review of the current state of the art in performance evaluation within territorial healthcare, while simultaneously outlining a set of conceptual elements capable of informing the future development of an evaluative framework aligned with the principles and objectives of Ministerial Decree No. 77/2022 and with the ongoing transformations of the Italian healthcare system.

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