Orientamento settoriale dei sistemi sanitari ed esiti di salute: una revisione narrativa della letteratura.

This study focuses on sectoral orientation, with particular attention to the prominence of primary care compared to secondary (or specialist) care. Some studies in comparative health policy suggest that a greater focus on primary care could lead to better aggregate health outcomes and a reduction in socio-economic health disparities. After addressing the challenges in accurately measuring the sectoral orientation of healthcare systems, we examine several contributions that analyse the relationship between sectoral orientation and health outcomes, both in aggregate terms and in terms of disparities across socio-economic groups. While there is broad consensus on the economic efficiency of systems oriented toward primary care – mainly due to the reduction of avoidable hospitalizations – the evidence gathered in this study does not conclusively demonstrate their overall superiority. Nonetheless, the complexity of conceptualizing and measuring healthcare sectoral orientation highlights the need for further research in this field.