Emergency medical services in crisis: an Italian case study.

This paper deals with the system of emergency medical services in Italy. More specifically, it is a case study of the organization and operation of this system in the region of Tuscany. Recent decentralization decrees have established regional governments with major responsibilities for health care, including emergency medical services. The effects of a long history of social and political cleavages on provision of these services at the regional level are presented and discussed. The paper concludes that prospects for rational reform of emergency care service are dim.