Protecting our health care workers while protecting our communities during the COVID-19 pandemic: a comparison of approaches and early outcomes in two Italian regions, Italy, 2020

Nancy Binkin; Stefania Salmaso; Federica Michieletto; Francesca Russo

With the aging of the Italian population and increasing health care costs, funding and personnel of regional public health programs have declined over the last two decades. The magnitude of the decline has varied between regions and increasing divergence across the regions has been observed in their relative emphasis on public health and curative services. In collaboration with the private sector, some regions, including Lombardy, have created an extensive network of curative services and hospitals but have decreased funding for public health field activities and public laboratories (4) . Others, such as Veneto, have continued to support a strong public health network with community outreach. Organizational changes have occurred over time that reflect the changing emphasis on curative services. In some regions, including Lombardy, public health services and hospitals have separate management structures, while in others, such as Veneto, most or all of the hospitals are managed by local health units that also provide preventive services. The response to the pandemic in the two regions reflects these differences.