Centralità del medico di medicina generale nel riordino delle cure primarie

In the 90’s in a number of Western countries, the reorganisation of primary care centred on the role of the general practitioner. This occurred later in Italy, but the country has now caught up with other countries. New organisational models of primary care (Utap) have been implemented and stronger incentives have been introduced to encourage General practitioners to assume more responsibility for quality of care and spending control. This paper looks at the relationship link between the more efficient organisation of primary care, more appropriate care and expenditure control. It begins with a description of organisational models of primary care used in Great Britain. It then gives details of arrangements for primary care in Italy and of most recent trade union contract for General practitioners. The new organisational model known as Utap is also discussed. Finally the first results of a reorganisation of primary care in a local health authority in the region of Veneto are presented.