Territorial Healthcare and Pandemic Preparedness: Insights from Bologna's “Casa Della Comunità"

The COVID-19 pandemic exposed significant weaknesses in global health governance and healthcare systems, exacerbating inequalities in access to essential care, especially for marginalized communities. This contribution examines the Italian experience, focusing on the Emilia-Romagna region, which has long been recognized for its advanced primary care model and its efforts to integrate health and social care. One of the key innovations in this region is the establishment of Case della Comunità (Community Health Centers, CdC), which should serve as hubs for both medical services and community-based health initiatives. This model is explored as a potential solution to strengthen pandemics (or syndemics) preparedness and improve response mechanisms in future health crises.

The case study is set in Navile, Bologna’s most populous neighbourhood, where a CdC recently launched an Urgent Assistance Center (CAU). This facility was designed to handle minor emergencies locally, thus alleviating the burden on emergency departments in larger hospitals. By examining this specific context, the study explores how localized health services can contribute to a more resilient health system capable of responding more efficiently to both everyday health needs and future pandemics. Using a mixed-method approach—including data analysis, semi-structured interviews with patients and healthcare workers, and participant observation—the research delves into the interactions between health services, the local community, and territorial organizations, paying special attention to how these actors participate in decision-making and service co-design.

In the wake of COVID-19, Italy’s National Recovery and Resilience Plan (PNRR) earmarked €18.5 billion for health reforms. These initiatives aim to modernize hospital infrastructure, digitize the National Health Service, and redesign territorial healthcare networks to improve access and equity. By analyzing the CdC in Bologna, this research assesses the impact of these reforms on proximity care, community participation, and the creation of new, inclusive spaces for health beyond traditional healthcare institutions.