[Quality and efficiency of the Health Service in the Italian Region of Lombardy]

The Regional Law No. 31 of 1997 has revised the Lombardy Health Service as a whole, separating "providers", credited Public and Private Health Institutions, from "purchasers", Local Health Agencies. To this purpose, the improvement of the quality of assistance has been enhanced through an accreditation process aimed at implementing second level regional requirements considered as being necessary for carrying out effective treatment and meeting patient needs. Training, implementation and evaluation of quality service within Health Institutions have been carried out with the assistance of the Regional Observatory on the Quality of Health Service, which helped to identify initial intervention areas, define process indicators, activities and outcomes and verify patient satisfaction, all this to improve performance, reduce risks and control costs. To fully develop the Institutions in the accreditation process, the complex and difficult aspect of health care quality has been more extensively and deeply dealt with by adopting an "Excellence accreditation" model in cooperation with the Joint Commission International Accreditation and by experimenting with Professional accreditation supported by Scientific Societies to further contribute to the development of technical skills and knowledge. The Quality Project carried out so far is based on the integration of various projects, which will be the object of practical interventions by the General Health Direction. All the information and results gathered from this project will be very helpful in finding solutions that will enable all Health Institutions in Lombardy to reach an adequate level of quality.