title: Integrating and rationalizing public healthcare services as a source of cost containment in times of economic crises.
abstract: BACKGROUND
  Serious concern has been raised about the sustainability of public health care systems of European Nations and ultimately about the health of European citizens, as a result of the economic crisis that has distressed Europe since 2008. The severe economic crisis of the Euro zone, which is still afflicting Europe in 2016, has in fact threatened to equally impact public health services of nations presenting either a weak or a strong domestic growth.
  
  
  CONCLUSIONS
  On behalf of the European Paediatric Association, the Union of National European Societies and Associations, the authors of the Commentary debates the relationship between the effects of economic instability and health, through the report on an article recently published in the Italian Journal of Pediatrics, which emphasized the importance of integrating existing public health care services, otherwise independently provided by public hospitals, and Primary Care Paediatric networks. The interconnections between the effects of economic instability and health are briefly commented, following the observation that these two factors are not yet fully understood, and that the definition of proper solutions to be applied in circumstances, where health is negatively impacted by periods of economic distress, is still open for discussion. Furthermore it is noted that the pressure to "deliver more for less" often seems to be the driving force forging the political strategic decisions in the area of pediatric healthcare, rather than social, cultural, and economic sensitivity and competences. Thus, the delivery of appropriate pediatric healthcare seems not to be related exclusively to motivations aimed to the benefit of children, but more often to other intervening factors, including economic, and political rationales.
  
  
  CONCLUSIONS
  The conclusions emphasize that local European experiences suggest that positive and cost effective healthcare programs are possible, and they could serve as a model in the development of effective cross-border regional program, not weakening the quality of services provided to children.
authors.affiliation: Institute of Pediatrics, University of Foggia, Via Pinto, 1, Foggia, 71100, Italy. massimo.pettoellomantovani@unifg.it.|European Paediatric Association, the Union of National European Paediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany. massimo.pettoellomantovani@unifg.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Pettoello-Mantovani
authors.affiliation: European Paediatric Association, the Union of National European Paediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany. namazova@nczd.ru.|Federal State Budgetary Institution "Scientific Centre of Children's Health" Moscow, Russian Federation, Moscow, Russia. namazova@nczd.ru.
authors.forename: Leyla
authors.initials: L
authors.lastname: Namazova-Baranova
authors.affiliation: European Paediatric Association, the Union of National European Paediatric Societies and Associations (EPA-UNEPSA), Berlin, Germany. Ehrich.Jochen@mh-hannover.de.|Children's Hospital, Hannover Medical School, Hannover, Germany. Ehrich.Jochen@mh-hannover.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Ehrich
mesh_terms: D003363:Cost Control; D019033:Delivery of Health Care, Integrated / Q000191:economics*; D006801:Humans; D038622:Internationality; D011634:Public Health / Q000191:economics*