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FrancoAngeli Journals

Contributi Scientifici

No. 74 (2026)

Il posizionamento strategico dei SerD nelle Case di Comunità: modelli di governance, stratificazione della domanda e sfide organizzative nell’era del DM 77/22

DOI
https://doi.org/10.3280/mis74-2026oa23183
Submitted
luglio 2, 2026
Published
2026-07-27

Abstract

The Ministerial Decree 77/22 establishes Community Houses (Case di Comunità - CdC) as the cornerstone of primary and community care. Facing resource scarcity, integrating Substance Use Disorder Services (Ser.D.) within these facilities serves as a strategic managerial lever to address “first-level” (low-intensity) needs among non-complex substance users. This paper analyzes the optimal skill mix for proximity multidisciplinary teams (psychologists, educators, social workers, nurses) and the enabling role of telehealth in supporting Hub-and-Spoke coordination with specialized secondary care. Finally, four operational clinical governance models (Referral, Consultation-Liaison, Stepped-Care, and Collaborative) are evaluated to guide healthcare executives between vertical disease-specific pathways or horizontal population health strategies, aimed at improving clinical appropriateness and reducing waiting lists.

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