Spending quality and sustainability for health care system and services

Assuring healthcare sustainability has always been representing the key challenge to be addressed. Enhancing a dynamic balance of economic, financial and social goals should drive health system governance and management. This balance is complex itself, due to: the multidimensional feature of both economic and social scope; the diversified target needs; the innovation paths. Sustainability is confirmed to be the cornerstone of health system governance in both PNRR and EU4Health programs; both call for an urgent perspective shift to a sustainability frame, intrinsically integrating all economic and social dimensions. This requires a deep innovation of the programming and control systems, grounded on a balanced system of efficiency, effectiveness, appropriateness and social impact indicators. These last will serve as a compass for the quality of public spending, within a renewed and integrated programming and control system and effective organizational networks.