# Enhancing patient accessibility of primary care: the redesign of Italian territorial medicine

## TL;DR

The paper explores how Community Healthcare Centers in Italy can improve access to primary care in urban and rural areas.

## Contribution

The study introduces and evaluates two strategies—capacity expansion and redistribution—to enhance healthcare accessibility through CHCs.

## Key findings

- CHCs can maintain and enhance future healthcare accessibility.
- Redistributing current capacity can improve accessibility without hiring new staff.
- Combining expansion and redistribution strategies maximizes future accessibility.

## Abstract

Ensuring widespread accessibility of healthcare services is a crucial policy objective. Accordingly, the Italian National Recovery and Resilience Plan (NRRP) has prioritized territorial medicine, channeling post-pandemic investments toward the restructuring of primary care services. A notable change is the establishment of Community Healthcare Centers (CHCs). This paper investigates how CHCs contribute to the accessibility of healthcare in urban and rural areas. By leveraging a comprehensive dataset of general practitioners’ availability and estimating future demand-and-supply scenarios, we examine the impact of CHCs under two different capacity allocation strategies. Strategy 1—Capacity expansion—involves allocating additional service hours of general practitioners to CHCs in order to maximize accessibility. Strategy 2—Capacity redistribution—accounts for the persistent shortage of healthcare professionals faced by Italy in the recent years by reallocating a portion of general practitioners’ current services from their existing workplace locations to CHCs. Our results indicate that CHCs have the potential to maintain current accessibility levels and also enhance them in the years to come. Moreover, we demonstrate that simply redistributing the current capacity can improve future accessibility. Finally, we show that a mix of the capacity expansion and redistribution strategies (Strategy 3) can maximize accessibility in the future, limiting the need for new professional staff.

Levers of future variations in accessibility of primary care are investigated.Community Healthcare Centers contribute to enhancing future accessibility of primary careCapacity expansion and redistribution are analyzed as alternative strategies.Improvement in future accessibility can be achieved even by redistributing capacity.

Levers of future variations in accessibility of primary care are investigated.

Community Healthcare Centers contribute to enhancing future accessibility of primary care

Capacity expansion and redistribution are analyzed as alternative strategies.

Improvement in future accessibility can be achieved even by redistributing capacity.