[Integrated patient-centered care in Community Health Centers in Italy: performance evaluation]

In Italy, a "Casa della Salute" (or "House of Health"), translated for the purposes of this article as Community Health Center (CHC), is a public center (of the national public healthcare system), where one can find allocated all primary community healthcare services centered on prevention, treatment and rehabilitation of the citizen in the same physical space, including general practitioner offices, outpatient specialist clinics, and social services. CHCs assure patient-centered primary care services and are the ideal place for applying the Chronic Care Model. We compared inpatient admission rates for all diseases and for chronic diseases, pharmaceutical and specialist expenditure, spending for implants and emergency room admissions, among persons assigned to General Practitioners (GPs) who work in CHCs compared with those in the same geographical area followed by GPs not working in a CHC. Subjects cared for in CHCs showed lower levels of hospital admission and emergency room access. Slight increases in the consumption of drugs and specialist resources, including consultation and diagnostic tests, were observed, due to increased taking charge of chronic cases in CHCs.