Health policy and children's health in Italy

Key words: Paediatric departments, Neonatal intensive care unit, Numbers, Appropriateness

In Italy the number of departments of Paediatrics and Neonatal Intensive Care Centres is still high. This study analyzes the causes of this phenomenon, which in many cases leads to low quality care and reduced levels of performance safety. This phenomenon occurs especially in smaller facilities that do not provide round the clock doctor-obstetrician and paediatric- neonatal services in the delivery room, in the wards and in the emergency unit. This problem contributes to keep a high rate of hospitalization for the inpatient, at risk of inappropriateness, with an irrational use of available resources, even during the neonatal period. The study also reiterates that the mortality in infants weighing less than 1,500 g is higher in facilities with low volumes of activity. A rationalization of hospitalization in the paediatric area could improve the quality of performance and lead to a reduction in the sanitary expenses.