Strumenti di supporto alle decisioni per la valutazione delle alternative localizzative dei servizi sanitari territoriali

As part of the territorial healthcare reform, supported by the PNRR Missione 6 Salute M6C1, some urgent decisions regarding the planning and programming of interventions for the implementation of local primary care facilities (i.e., Case di Comunità e Ospedali di Comunità) have been taken to respond to the tight timing, without a careful assessment of user needs, feasibility, and contextual situations. Indeed, behind the interpretative rethinking of the socio-health organization based on a network of primary care services, there was the intent to bring health services closer to the daily life of citizens, enhancing its social aspects and giving a central role to cities and the territory as effective factors to root new lifestyles and active participation of communities. Instead, the rapid acceleration of decision-making processes led regions to locate these facilities in sites and buildings chosen since their availability, often disregarding the strategic objectives of a social, cultural, environmental, climatic, and functional nature to which these interventions on the territory were supposed to respond. The regional development program would require (i) an accurate interdisciplinary analysis to formulate localization proposals in line with urban planning policies and municipal plans; (ii) the use of methodologies and predictive tools, such as Multicriteria Decision Analysis (MCDA), to compare the different available options. With reference to investment M6C1 -3 - Case di Comunità e presa in carico della persona - and considering the planned locations for the “Case di Comunità” (CdC) in the territory of the municipality of Rome (ASL RM 1, 2, 3), this contribution intends to illustrate an application of MCDA to evaluate the localization choices of the CdCs identified within the intervention macro-category Redevelopment of disused buildings, constituting 5% of the 60 planned interventions for the municipality of Rome.