Il posizionamento strategico dei SerD nelle Case di Comunità: modelli di governance, stratificazione della domanda e sfide organizzative nell’era del DM 77/22

Journal title MISSION
Author/s Felice Alfonso Nava
Publishing Year 2026 Issue 2026/74
Language Italian Pages 3 P. 36-38 File size 0 KB
DOI 10.3280/mis74-2026oa23183
DOI is like a bar code for intellectual property: to have more infomation click here

View article Download Open Access article

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

The Ministerial Decree 77/22 establishes Community Houses (Case di Comunità - CdC) as the cornerstone of primary and community care. Facing resource scarcity, integrating Substance Use Disorder Services (Ser.D.) within these facilities serves as a strategic managerial lever to address “first-level” (low-intensity) needs among non-complex substance users. This paper analyzes the optimal skill mix for proximity multidisciplinary teams (psychologists, educators, social workers, nurses) and the enabling role of telehealth in supporting Hub-and-Spoke coordination with specialized secondary care. Finally, four operational clinical governance models (Referral, Consultation-Liaison, Stepped-Care, and Collaborative) are evaluated to guide healthcare executives between vertical disease-specific pathways or horizontal population health strategies, aimed at improving clinical appropriateness and reducing waiting lists.

Keywords: DM 77/2022;Community Health Centers;Addiction Services (Ser.D.);Health and Social Care Integration;Population Needs Stratifi cation;Healthcare Management

  1. Decreto Ministeriale 23 maggio 2022, n. 77: Regolamento recante la definizione di modelli e standard per lo sviluppo dell’assistenza territoriale nel Servizio sanitario nazionale. Gazzetta Ufficiale della Repubblica Italiana, 144.
  2. Du C.X., Shi J., Tetrault J.M., Madden L.M., & Barry D.T. (2022). Primary care and medication management characteristics among patients receiving office-based opioid treatment with buprenorphine. Family Practice, 39(2): 234-240.
  3. Kates N., Mazowita G., Lemire F. et al. (2011). The evolution of collaborative mental health care in Canada: a shared vision for the future. The Canadian Journal of Psychiatry, 56(5): 1-10.
  4. Lovén Wickman U., & Schmidt M. (2023). Experiences of primary care among young adults with mental illness – A systematic literature
  5. review. Scandinavian Journal of Caring Sciences, 37(3): 628-641.
  6. Molfenter T., Roget N., Chaple M., Behlman S., Cody O., Hartzler B., Johnson E., Nichols M., Stilen P., & Becker S. (2021). Use of telehealth in substance use disorder services during and after COVID-19: online survey study. JMIR Mental Health, 8(2), e25835.
  7. Oldham M.A., Desan P.H., Lee H.B., Bourgeois J.A., Shah S.B., Hurley P.J., Sockalingam S., Council on Consultation-Liaison Psychiatry (2021). Joint Commission Requirements and Consultation-Liaison Psychiatry. Journal of the Academy of Consultation-Liaison Psychiatry, 62(2): 169-185.
  8. Panagiotoglou D., McCracken R., Lavergne M.R., Strumpf E.C., Gomes T., Fisher B., Brackett A., Johnson C., & Kendall P. (2020). Evaluating the intended and unintended consequences of opioid-prescribing interventions on primary care in British Columbia, Canada: protocol for a retrospective population-based cohort study. BMJ Open, 10(11), e038724.
  9. Rombouts S.A., Conigrave J.H., Saitz R., Louie E., Haber P., & Morley K.C. (2020). Evidence-based models of care for the treatment of alcohol use disorder in primary health care settings: a systematic review. BMC Family Practice, 21(2): 260.
  10. Taylor J.L., Wakeman S.E., Walley A.Y., & Kehoe L.G. (2023). Substance use disorder bridge clinics: models, evidence, and future directions. Addiction Science & Clinical Practice, 18(1): 23.
  11. Villanueva-Blasco V.J., Eslava D., Olave L., & Torrens M. (2024). Electronic interventions in primary care to address substance use: a systematic review. Addictive Behaviors, 156, 108073.

Felice Alfonso Nava, Il posizionamento strategico dei SerD nelle Case di Comunità: modelli di governance, stratificazione della domanda e sfide organizzative nell’era del DM 77/22 in "MISSION" 74/2026, pp 36-38, DOI: 10.3280/mis74-2026oa23183