Appropriateness in allergic respiratory diseases health care in Italy: definitions and organizational aspects.
In a historical period in which sustainability of the National Health Service is mandatory because of the international economical situation, the limited available resources at national level and the tendency of passing from a "population medicine" model towards the concept of "individualized medicine", the debate on appropriateness of medical and surgical procedures is of central importance. The choosing wisely campaign, started in United States in 2012 and then spread all over the world, tries to summarize which are the most inappropriate procedures for each medical and surgical speciality; as far as allergic respiratory diseases, the most relevant Italian societies and the American Academy defined the allergological procedures with the highest probability of inappropriateness. In Italy, a recent decree of the Ministry of Health defined a list of more than 200 procedures that will be considered as inappropriate in certain conditions; many of these procedures concern allergology, including allergic respiratory diseases. In this commentary we discuss the above mentioned decree and the concept of appropriateness in the field of allergic respiratory diseases, trying to figure out some practical considerations based on the current health resources available in the field of allergology in Italy.
Departmental Unit of Allergology-Clinical Immunology and Respiratory Diseases, Fondazione Poliambulanza of Brescia, Via Bissolati, 57, Brescia, Italy.
Carlo
C
Lombardi
Departmental Unit of Allergology, AUSL of Piacenza, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.
Eleonora
E
Savi
Unit of Allergology, Department of Internal Medicine, Azienda Ospedaliera "Carlo Poma" of Mantua, Mantua, Italy.
Maria Teresa
MT
Costantino
Respiratory Medicine and Allergy-Department Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Enrico
E
Heffler
Unit of Pulmonology, S. Corona Hospital, Pietra Ligure, Savona, Italy.
Manlio
M
Milanese
Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.
Giovanni
G
Passalacqua
Allergy and Respiratory Diseases, IRCCS San Martino-IST-University of Genoa, Genoa, Italy.
Giorgio Walter
GW
Canonica
Allergology; Appropriateness; Choosing wisely; Health resources; Italy; National Health System; Slow medicine