The increasing problem of population aging and the hospital retraining process have imposed in the last years a radical change in the health strategies with a particular attention to the development of home care projects.
The modern assistance models require, however, a strong increase of the organizational flexibility and new managerial tools, with the aim to assure the appropriateness and the effectiveness of the interventions, the sustainability of the models, the citizens’ pleasure, the professional quality.
The specific objectives pursued by Home Care technologies are as follows:
- assistance to patients with conditions that can be treated at home, improving the quality of life;
- support for family, transmitting any skills necessary for independent action;
- facilitation in the supply of assistive technology.
The home care models that prevail in our country are determined in large part by the characteristics of this welfare system, and its features of fragmentation. A set of prevalent models can be briefly identified.
Among the models described, the one that is now more widespread is the Integrated Home Care (ADI). But the lack of analysis specifically aimed to an economic assessment of the aspects related to frail patients assistance, makes difficult for the national and regional stakeholders the reallocation of human and material resources and the determination of a specific charging system, aimed to guarantee the economic balance and the sustainability of the home care structures.
An important experience has developed in the Piedmont Region: the Home Hospitalization, that the National Health Plan defines as “the ways in which health care facilities, in view of special evaluations, follow their own staff directly at home, for patients who require a hospital level of assistance".

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Key words: Home Care, home assistance, effectiveness, appropriateness, frail patients