Italian National Recovery and Resilience Plan: a Healthcare Renaissance after the COVID-19 crisis? Recovery and Resilience beyond COVID-19

Italian National Recovery and Resilience Plan: a Healthcare Renaissance after the COVID-19 crisis?

Recovery and Resilience beyond COVID-19


  • Tommaso Filippini CREAGEN - Environmental, Genetic and Nutritional Epidemiology Research Center, Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
  • Silvio Roberto Vinceti Departiment of Law, University of Modena and Reggio Emilia, Modena, Italy


COVID-19, resilience, recovery, healthcare, National Recovery and Resilience Plan, digital innovation, community


Proposed for the first time by European Commission in May 2020, the “NextGenerationEU” (NGEU) program is the European Union’s most important effort to address key issues relating to public health and healthcare, digital and technological innovation, climate change, sustainable mobility, and key sociocultural aspects. In addition, the NGEU represents a response to the COVID-19 crisis through an extremely powerful financial intervention (over 800 billion euros). Italy is one of the main recipients of the NGEU plan’s resources with almost 200 billion euros received in grants and loans. Implementation of the NGEU in Italy will take place through the National Recovery and Resilience Plan (NRRP). The NRRP not only describes how the NGEU resources will be used, but it singles out crucial public law reforms in national legislation and organization. Unsurprisingly, public health intervention represents a major component of the NRRP. Here we summarize and discuss the rules, regulations and perspective envisaged by the NRRP to foster effective healthcare and to reshape the Italian National Health System through the redesigning of primary care, enhanced communication between hospital and community healthcare, and stronger implementation of digital technologies in public health. (


Picek O. Spillover effects from Next Generation EU. Inter Econ 2020; 55 (5): 325-31.

Alcidi C, Gros D. Next Generation EU: A large common response to the COVID-19 crisis. Inter Econ 2020; 55 (4): 202-3.

Vinceti M, Filippini T, Rothman KJ, et al. SARS-CoV-2 infection incidence during the first and second COVID-19 waves in Italy. Environ Res 2021; 197: 111097.

Filippini T, Zagnoli F, Bosi M, et al. An assessment of case-fatality and infection-fatality rates of first and second COVID-19 waves in Italy. Acta Biomed 2021; 92 (e2021420).

European Commission. Recovery plan for Europe. 2021. Accessed September 27, 2021.

National Recovery and Resilience Plan. 2021. Accessed September 27, 2021.

NextGenerationEU. Recovery plan for Europe. 2021. Accessed September 27, 2021.

Piccinni C, Calabria S, Ronconi G, et al. [Facts and figures of clinical pathways in Italy: Results from the PDTA Net project.]. Recenti Prog Med 2019; 110 (4): 188-94.

Capolongo S, Gola M, Brambilla A, et al. COVID-19 and healthcare facilities: A decalogue of design strategies for resilient hospitals. Acta Biomed 2020; 91 (9-S): 50-60.

Hilty DM, Ferrer DC, Parish MB, et al. The effectiveness of telemental health: A 2013 review. Telemed J E Health 2013; 19 (6): 444-54.

Benski AC, Schmidt NC, Viviano M, et al. Improving the quality of antenatal care using mobile health in Madagascar: Five-year cross-sectional study. JMIR Mhealth Uhealth 2020; 8 (7): e18543.

de la Torre-Diez I, Lopez-Coronado M, Vaca C, et al. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: A systematic review. Telemed J E Health 2015; 21 (2): 81-5.

Jiang X, Ming WK, You JH. The cost-effectiveness of digital health interventions on the management of cardiovascular diseases: Systematic review. J Med Internet Res 2019; 21 (6): e13166.

Donald M, Jackson CL, Byrnes J, et al. Community-based integrated care versus hospital outpatient care for managing patients with complex type 2 diabetes: Costing analysis. Aust Health Rev 2021; 45 (1): 42-50.

De Marchi F, Contaldi E, Magistrelli L, et al. Telehealth in neurodegenerative diseases: Opportunities and challenges for patients and physicians. Brain Sci 2021; 11 (2): 237.

Bashshur R, Doarn CR, Frenk JM, et al. Telemedicine and the COVID-19 pandemic, lessons for the future. Telemed J E Health 2020; 26 (5): 571-3.

Guarino M, Cossiga V, Fiorentino A, et al. Use of telemedicine for chronic liver disease at a single care center during the COVID-19 pandemic: Prospective observational study. J Med Internet Res 2020; 22 (9): e20874.

Maietti E, Sanmarchi F, Palestini L, et al. The experience of patients with diabetes with the use of telemedicine and teleassistance services during the COVID-19 pandemic in Italy: Factors associated with perceived quality and willingness to continue. Diabetes Res Clin Pract 2021: 109047.

Shirke MM, Shaikh SA, Harky A. Implications of telemedicine in oncology during the COVID-19 pandemic. Acta Biomed 2020; 91 (3): e2020022.

Vasta R, Moglia C, D'Ovidio F, et al. Telemedicine for patients with amyotrophic lateral sclerosis during COVID-19 pandemic: An Italian ALS referral center experience. Amyotroph Lateral Scler Frontotemporal Degener 2021; 22 (3-4): 308-11.

Vinceti M, Filippini T, Rothman KJ, et al. Lockdown timing and efficacy in controlling COVID-19 using mobile phone tracking. EClinicalMedicine 2020; 25: 100457.

Odone A, Lugo A, Amerio A, et al. COVID-19 lockdown impact on lifestyle habits of Italian adults. Acta Biomed 2020; 91 (9-S): 87-9.

Amerio A, Lugo A, Stival C, et al. COVID-19 lockdown impact on mental health in a large representative sample of Italian adults. J Affect Disord 2021; 292: 398-404.

Amerio A, Odone A, Marzano L, et al. COVID-19: The last call for telepsychiatry. Acta Biomed 2020; 91 (3): ahead of print.

Bitar H, Alismail S. The role of eHealth, telehealth, and telemedicine for chronic disease patients during COVID-19 pandemic: A rapid systematic review. Digit Health 2021; 7: 20552076211009396.

Li Q, Wang L, Wang B, et al. The COVID-19-designated hospitals in China: Preparing for public health emergencies. Emerg Microbes Infect 2021; 10 (1): 998-1001.

Sacchetto D, Raviolo M, Beltrando C, et al. COVID-19 surge capacity solutions: Our experience of converting a concert hall into a temporary hospital for mild and moderate COVID-19 patients. Disaster Med Public Health Prep 2020: 1-4.

Liwanag V. FieraMilanoCity repurposed into a temporary hospital in 10 days. ArchiExpo e-Magazine. 2020. Accessed September 27, 2021.

Signorelli C, Odone A, Oradini-Alacreu A, et al. Universal Health Coverage in Italy: Lights and shades of the Italian National Health Service which celebrated its 40th anniversary. Health Policy 2020; 124 (1): 69-74.

Balzarini F, Frascella B, Oradini-Alacreu A, et al. Does the use of personal electronic health records increase vaccine uptake? A systematic review. Vaccine 2020; 38 (38): 5966-78.

Demurtas J, Tonelli R, Celotto S, et al. [COVID-Guide: An app for covid-19 triage and self-assessment]. Recenti Prog Med 2021; 112 (5): 387-91.

Decreto Legge 31 maggio 2021, n. 77.

Decreto Legge 9 giugno 2021, n. 80.

Morana D. Tutela della salute. In: Guzzetta G, Marini FS, Morana D, editors. Le materie di competenza regionale. Napoli: ESI; 2015. p. 583-601.

European Commission. Council Implementation Decision on the approval of the assessment of the recovery and resilience plan for Italy. Brussels 22.6.2021 COM(2021) 344 final. 2021/0168 (NLE). Brussels. Accessed September 27, 2021.

European Commission. Annex to the proposal for a Council Implementing Decision on the approval of the assessment of the recovery and resilience plan for Italy. Brussels, 22.6.2021 COM(2021) 344 final. Annex. Accessed September 27, 2021.

Fassari L. “L’attuale profilo di Medici di famiglia e pediatri convenzionati non è più adeguato ai nuovi bisogni di assistenza. Il futuro è nelle Case della Comunità”. Dalla dipendenza a nuove forme di accreditamento, ecco le proposte delle Regioni. Quotidiano Sanità. 2021. Accessed September 27, 2021.

Medici di famiglia dipendenti? L’altolà Enpam: “Riforma così com’è provoca 84 mld di danni”. Quotidiano Sanità. 2021. Accessed September 27, 2021.

Garattini L, Curto A, Freemantle N. Access to primary care in Italy: time for a shake-up? Eur J Health Econ 2016; 17 (2): 113-6.

Vedovetto A, Soriani N, Merlo E, et al. The burden of inappropriate emergency department pediatric visits: Why Italy needs an urgent reform. Health Serv Res 2014; 49 (4): 1290-305.




How to Cite

Filippini T, Vinceti SR. Italian National Recovery and Resilience Plan: a Healthcare Renaissance after the COVID-19 crisis? Recovery and Resilience beyond COVID-19 . Acta Biomed [Internet]. 2021 Nov. 17 [cited 2024 Jul. 19];92(S6):e2021463. Available from: