{"id":{"repo_id":"dialnet","oai_identifier":"oai:dialnet.unirioja.es:TES0000023241"},"canonical_url":"https://search.dev.ndltd.org/etd/dialnet/oai:dialnet.unirioja.es:TES0000023241","repository":{"repo_id":"dialnet","name":"Dialnet","base_url":"https://dialnet.unirioja.es/oaites/OAIHandler"},"display":{"title":"Modelos de sistemas sanitarios en el contexto Mediterráneo: el caso de La Rioja y Cerdeña","abstract":"This study explains how !he definition ot health and thus, !he right to health, is incorporated into !he legal systems of different countries, since there is no unanimous consensus worldwide. To this end, a comparative study has been carried out between two European regions that reveals similarities and differences trom !he legal and social point of view. Two regions have been selected: !he Spanish and ltalian penínsulas, which share roots and cultures as well as similar traditions for their common characteristics. To limit !he field of !he research, a case study was carried out in each of the two regions: !he Autonomous Community ot La Rioja and !he Region ot Sardinia, and in particular the cities ot Logroño and Sassari, which are easily comparable in size and sociodemographic characteristics. Since two systems that were born and developed under very different historical, legal and social conditions have been compared, it has been considered indispensable to trame, in !he first place, !he two health systems from !he historical and legal point of view. The first chapter has been devoted to !he analysis ot health concept from a historical and legal perspective. Health determinants throughout history have been examined to understand the debate about the primacy ot individual factors over population factors, or vice versa, as occurred during !he pandemic. Then, the complex nature of the right to health and its philosophical-legal basis as a social right protected both by international norms and by the laws ot Spain and ltaly has been investigated. In addition, since both countries have a decentralized health system, an attempt has been made to further study their health systems al !he territorial level. Since to study a phenomenon is good practice to approach the territory to understand what type of health coverage these countries offer, the work has gone into !he analysis ot two territorial realilies (La Rioja and Sardinia) looking al them from !he practical point of view. The health and social services offered by both systems have been analyzed, always taking into account the variety and differences between their statutes. In addition, to check whether health systems respond to !he user's health needs and what is !he level of satisfaction ot !he citizen with health services in !he two territorial realities, a survey has been carried out that, gathering the opinions ot the citizens, has highlighted the nuances and features of both systems. Finally, through an effort ot inductive abstraction that allowed to move from a particular perspective to a general view, it has been attempted to go beyond !he vision of the single individual to obtain, initially, an objective and then more general perspective of the phenomenon under study. The strong impact on health systems caused by the 2020 health crisis has torced us to reconsider that health cannot be understood without disease and prevention. First, society has aged and thus the social context is changed from !he past. However, there is an increase in the control of diseases that become chronic with a high survival rate and a marked increase in lite expectancy. This context is causing us to rethink, not jusi a redefinition ot the concept of health, but how to readjust regulalions and health systems themselves. This analysis makes it possible to understand, from the legal and social point ot view, whether !he health systems in La Rioja and Sardinia continue to mee! !he population's health needs or it something has changed. 11 also wants to show whether the right to health, which is universally recognized as a human right by !he international community, is being applied and how it is being implemented. Finally, il allows us to understand, trom a more general point gfyiew, whether !he model of the welfare state ap lied in both countries remains the same or has changed after 2020.","abstract_html":"This study explains how !he definition ot health and thus, !he right to health, is incorporated into !he legal systems of different countries, since there is no unanimous consensus worldwide. To this end, a comparative study has been carried out between two European regions that reveals similarities and differences trom !he legal and social point of view. Two regions have been selected: !he Spanish and ltalian penínsulas, which share roots and cultures as well as similar traditions for their common characteristics. To limit !he field of !he research, a case study was carried out in each of the two regions: !he Autonomous Community ot La Rioja and !he Region ot Sardinia, and in particular the cities ot Logroño and Sassari, which are easily comparable in size and sociodemographic characteristics. Since two systems that were born and developed under very different historical, legal and social conditions have been compared, it has been considered indispensable to trame, in !he first place, !he two health systems from !he historical and legal point of view. The first chapter has been devoted to !he analysis ot health concept from a historical and legal perspective. Health determinants throughout history have been examined to understand the debate about the primacy ot individual factors over population factors, or vice versa, as occurred during !he pandemic. Then, the complex nature of the right to health and its philosophical-legal basis as a social right protected both by international norms and by the laws ot Spain and ltaly has been investigated. In addition, since both countries have a decentralized health system, an attempt has been made to further study their health systems al !he territorial level. Since to study a phenomenon is good practice to approach the territory to understand what type of health coverage these countries offer, the work has gone into !he analysis ot two territorial realilies (La Rioja and Sardinia) looking al them from !he practical point of view. The health and social services offered by both systems have been analyzed, always taking into account the variety and differences between their statutes. In addition, to check whether health systems respond to !he user's health needs and what is !he level of satisfaction ot !he citizen with health services in !he two territorial realities, a survey has been carried out that, gathering the opinions ot the citizens, has highlighted the nuances and features of both systems. Finally, through an effort ot inductive abstraction that allowed to move from a particular perspective to a general view, it has been attempted to go beyond !he vision of the single individual to obtain, initially, an objective and then more general perspective of the phenomenon under study. The strong impact on health systems caused by the 2020 health crisis has torced us to reconsider that health cannot be understood without disease and prevention. First, society has aged and thus the social context is changed from !he past. However, there is an increase in the control of diseases that become chronic with a high survival rate and a marked increase in lite expectancy. This context is causing us to rethink, not jusi a redefinition ot the concept of health, but how to readjust regulalions and health systems themselves. This analysis makes it possible to understand, from the legal and social point ot view, whether !he health systems in La Rioja and Sardinia continue to mee! !he population's health needs or it something has changed. 11 also wants to show whether the right to health, which is universally recognized as a human right by !he international community, is being applied and how it is being implemented. Finally, il allows us to understand, trom a more general point gfyiew, whether !he model of the welfare state ap lied in both countries remains the same or has changed after 2020.","abstract_has_math":false,"creators":["Bonelli, Alessandra"],"institution":"Universidad de La Rioja (España)","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Caparrós Civera, Neus (null)","Anaut Bravo, Sagrario (null)"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2026,"date_issued":"2026","date_published":"2026","updated_at":"2026-07-24T06:27:11Z","subjects":[],"languages":["spa"],"rights":["LICENCIA DE USO: Los documentos a texto completo incluidos en Dialnet son de acceso libre y propiedad de sus autores y/o editores. Por tanto, cualquier acto de reproducción, distribución, comunicación pública y/o transformación total o parcial requiere el consentimiento expreso y escrito de aquéllos. Cualquier enlace al texto completo de estos documentos deberá hacerse a través de la URL oficial de éstos en Dialnet. Más información: https://dialnet.unirioja.es/info/derechosOAI | INTELLECTUAL PROPERTY RIGHTS STATEMENT: Full text documents hosted by Dialnet are protected by copyright and/or related rights. This digital object is accessible without charge, but its use is subject to the licensing conditions set by its authors or editors. Unless expressly stated otherwise in the licensing conditions, you are free to linking, browsing, printing and making a copy for your own personal purposes. All other acts of reproduction and communication to the public are subject to the licensing conditions expressed by editors and authors and require consent from them. Any link to this document should be made using its official URL in Dialnet. More info: https://dialnet.unirioja.es/info/derechosOAI"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://dialnet.unirioja.es/servlet/oaites?codigo=404148","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Caparrós Civera, Neus (null)","Anaut Bravo, Sagrario (null)"]},{"key":"dc:creator","label":"Author","values":["Bonelli, Alessandra"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2026"]},{"key":"dc:publisher","label":"Institution","values":["Universidad de La Rioja (España)"]},{"key":"dc:type","label":"Dc Type","values":["text (thesis)"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["spa"]},{"key":"dc:rights","label":"Dc Rights","values":["LICENCIA DE USO: Los documentos a texto completo incluidos en Dialnet son de acceso libre y propiedad de sus autores y/o editores. Por tanto, cualquier acto de reproducción, distribución, comunicación pública y/o transformación total o parcial requiere el consentimiento expreso y escrito de aquéllos. Cualquier enlace al texto completo de estos documentos deberá hacerse a través de la URL oficial de éstos en Dialnet. Más información: https://dialnet.unirioja.es/info/derechosOAI | INTELLECTUAL PROPERTY RIGHTS STATEMENT: Full text documents hosted by Dialnet are protected by copyright and/or related rights. This digital object is accessible without charge, but its use is subject to the licensing conditions set by its authors or editors. Unless expressly stated otherwise in the licensing conditions, you are free to linking, browsing, printing and making a copy for your own personal purposes. All other acts of reproduction and communication to the public are subject to the licensing conditions expressed by editors and authors and require consent from them. Any link to this document should be made using its official URL in Dialnet. More info: https://dialnet.unirioja.es/info/derechosOAI"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://dialnet.unirioja.es/servlet/oaites?codigo=404148"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["This study explains how !he definition ot health and thus, !he right to health, is incorporated into !he legal systems of different countries, since there is no unanimous consensus worldwide. To this end, a comparative study has been carried out between two European regions that reveals similarities and differences trom !he legal and social point of view. Two regions have been selected: !he Spanish and ltalian penínsulas, which share roots and cultures as well as similar traditions for their common characteristics. To limit !he field of !he research, a case study was carried out in each of the two regions: !he Autonomous Community ot La Rioja and !he Region ot Sardinia, and in particular the cities ot Logroño and Sassari, which are easily comparable in size and sociodemographic characteristics. Since two systems that were born and developed under very different historical, legal and social conditions have been compared, it has been considered indispensable to trame, in !he first place, !he two health systems from !he historical and legal point of view. The first chapter has been devoted to !he analysis ot health concept from a historical and legal perspective. Health determinants throughout history have been examined to understand the debate about the primacy ot individual factors over population factors, or vice versa, as occurred during !he pandemic. Then, the complex nature of the right to health and its philosophical-legal basis as a social right protected both by international norms and by the laws ot Spain and ltaly has been investigated. In addition, since both countries have a decentralized health system, an attempt has been made to further study their health systems al !he territorial level. Since to study a phenomenon is good practice to approach the territory to understand what type of health coverage these countries offer, the work has gone into !he analysis ot two territorial realilies (La Rioja and Sardinia) looking al them from !he practical point of view. The health and social services offered by both systems have been analyzed, always taking into account the variety and differences between their statutes. In addition, to check whether health systems respond to !he user's health needs and what is !he level of satisfaction ot !he citizen with health services in !he two territorial realities, a survey has been carried out that, gathering the opinions ot the citizens, has highlighted the nuances and features of both systems. Finally, through an effort ot inductive abstraction that allowed to move from a particular perspective to a general view, it has been attempted to go beyond !he vision of the single individual to obtain, initially, an objective and then more general perspective of the phenomenon under study. The strong impact on health systems caused by the 2020 health crisis has torced us to reconsider that health cannot be understood without disease and prevention. First, society has aged and thus the social context is changed from !he past. However, there is an increase in the control of diseases that become chronic with a high survival rate and a marked increase in lite expectancy. This context is causing us to rethink, not jusi a redefinition ot the concept of health, but how to readjust regulalions and health systems themselves. This analysis makes it possible to understand, from the legal and social point ot view, whether !he health systems in La Rioja and Sardinia continue to mee! !he population's health needs or it something has changed. 11 also wants to show whether the right to health, which is universally recognized as a human right by !he international community, is being applied and how it is being implemented. Finally, il allows us to understand, trom a more general point gfyiew, whether !he model of the welfare state ap lied in both countries remains the same or has changed after 2020.","Este estudio explica cómo se incorpora la definición de salud y, por consiguiente, el derecho a la salud en los ordenamientos jurídicos de diferentes países, ya que no existe un consenso unánime a nivel mundial. Con este fin, se ha llevado a cabo un estudio comparativo entre dos regiones europeas que revela similitudes y diferencias desde el punto de vista jurídico y social. Se han seleccionado dos regiones: las penínsulas española e italiana, que comparten raices y culturas, asi como tradiciones similares por sus características comunes. Para limitar el campo del estudio, se realizó un estudio de caso en cada una de las dos regiones: la Comunidad Autónoma de La Rioja y la Región de Cerdeña, y en particular las ciudades de Logroño y Sassari, que son fácilmente comparables en cuanto a tamaño y características sociodemográficas. Como se han comparado dos sistemas que nacieron y se desarrollaron en condiciones históricas, jurídicas y sociales muy diferentes, se ha considerado indispensable encuadrar, en primer lugar, los dos sistemas de salud desde el punto de vista histórico y jurídico. Se ha dedicado el primer capítulo al análisis de concepto de salud desde una perspectiva histórica y legal. Se han examinado los determinantes de salud a lo largo de la historia para comprender el debate sobre la primacía de los factores individuales sobre los de la población o viceversa, como sucedió durante la pandemia. Luego se ha investigado la compleja naturaleza del derecho a la salud y su fundamentación filosófico-jurídica como derecho social protegido, tanto por las normas internacionales como por las leyes de España e Italia. Además, considerando que ambos países tienen un sistema sanitario descentralizado, se ha intentado profundizar el estudio sus Sistemas Sanitarios a nivel territorial. Como para estudiar un fenómeno es buena práctica acercarse al territorio para comprender qué tipo de cobertura sanitaria ofrecen estos países, el trabajo se ha adentrado en el análisis de dos realidades territoriales (La Rioja y Cerdeña) mirándolos desde el punto de vista práctico. Se han analizado los servicios sanitarios y sociales ofrecidos por ambos Sistemas, siempre teniendo en cuenta la variedad y diferencias entre sus estatutos. Además, para comprobar si los sistemas de salud responden a las necesidades de falta de salud del usuario y cuál es el nivel de satisfacción del ciudadano por los servicios sanitarios en las dos realidades territoriales, se ha realizado una encuesta que, recogiendo las opiniones de la ciudadanía, ha puesto de relieve los matices y rasgos de ambos sistemas. Por último, a través de un esfuerzo de abstracción inductivo que permitiera pasar de una perspectiva particular a una visión general, se ha intentado ir más allá de la visión del solo individuo para obtener, inicialmente, una perspectiva objetiva y, luego, más general del fenómeno objeto de estudio. El fuerte impacto sobre los sistemas sanitarios causado por la crisis sanitaria de 2020 nos ha obligado a reconsiderar que la salud no puede entenderse sin enfermedad y sin prevención. En primer lugar, la sociedad ha envejecido y, por consiguiente, el contexto social es cambiado con respecto al pasado. Sin embargo, hay un aumento en el control de las enfermedades que se vuelven crónicas con una alta tasa de supervivencia y un marcado aumento en la esperanza de vida. Este contexto nos está haciendo repensar, no sólo una redefinición del concepto de salud, sino cómo reajustar las regulaciones y los propios sistemas de salud. Este análisis permite comprender, desde el punto de vista jurídico y social, sí los sistemas sanitarios de La Rioja y de Cerdeña siguen respondiendo a las necesidades sanitarias de la población o si algo ha cambiado. También quiere mostrar si el derecho a la salud, que es universalmente reconocido como un derecho humano por la comunidad internacional, se aplica y cómo se está implementando. En fin, nos permite comprender, desde un punto de vista más general, si el modelo del estado del bienestar aplicado en ambos países sigue siendo el mismo o ha cambiado después de 2020."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Modelos de sistemas sanitarios en el contexto Mediterráneo: el caso de La Rioja y Cerdeña"]}]}],"canonical_facts":{"dc:contributor":["Caparrós Civera, Neus (null)","Anaut Bravo, Sagrario (null)"],"dc:creator":["Bonelli, Alessandra"],"dc:date":["2026"],"dc:description":["This study explains how !he definition ot health and thus, !he right to health, is incorporated into !he legal systems of different countries, since there is no unanimous consensus worldwide. To this end, a comparative study has been carried out between two European regions that reveals similarities and differences trom !he legal and social point of view. Two regions have been selected: !he Spanish and ltalian penínsulas, which share roots and cultures as well as similar traditions for their common characteristics. To limit !he field of !he research, a case study was carried out in each of the two regions: !he Autonomous Community ot La Rioja and !he Region ot Sardinia, and in particular the cities ot Logroño and Sassari, which are easily comparable in size and sociodemographic characteristics. Since two systems that were born and developed under very different historical, legal and social conditions have been compared, it has been considered indispensable to trame, in !he first place, !he two health systems from !he historical and legal point of view. The first chapter has been devoted to !he analysis ot health concept from a historical and legal perspective. Health determinants throughout history have been examined to understand the debate about the primacy ot individual factors over population factors, or vice versa, as occurred during !he pandemic. Then, the complex nature of the right to health and its philosophical-legal basis as a social right protected both by international norms and by the laws ot Spain and ltaly has been investigated. In addition, since both countries have a decentralized health system, an attempt has been made to further study their health systems al !he territorial level. Since to study a phenomenon is good practice to approach the territory to understand what type of health coverage these countries offer, the work has gone into !he analysis ot two territorial realilies (La Rioja and Sardinia) looking al them from !he practical point of view. The health and social services offered by both systems have been analyzed, always taking into account the variety and differences between their statutes. In addition, to check whether health systems respond to !he user's health needs and what is !he level of satisfaction ot !he citizen with health services in !he two territorial realities, a survey has been carried out that, gathering the opinions ot the citizens, has highlighted the nuances and features of both systems. Finally, through an effort ot inductive abstraction that allowed to move from a particular perspective to a general view, it has been attempted to go beyond !he vision of the single individual to obtain, initially, an objective and then more general perspective of the phenomenon under study. The strong impact on health systems caused by the 2020 health crisis has torced us to reconsider that health cannot be understood without disease and prevention. First, society has aged and thus the social context is changed from !he past. However, there is an increase in the control of diseases that become chronic with a high survival rate and a marked increase in lite expectancy. This context is causing us to rethink, not jusi a redefinition ot the concept of health, but how to readjust regulalions and health systems themselves. This analysis makes it possible to understand, from the legal and social point ot view, whether !he health systems in La Rioja and Sardinia continue to mee! !he population's health needs or it something has changed. 11 also wants to show whether the right to health, which is universally recognized as a human right by !he international community, is being applied and how it is being implemented. Finally, il allows us to understand, trom a more general point gfyiew, whether !he model of the welfare state ap lied in both countries remains the same or has changed after 2020.","Este estudio explica cómo se incorpora la definición de salud y, por consiguiente, el derecho a la salud en los ordenamientos jurídicos de diferentes países, ya que no existe un consenso unánime a nivel mundial. Con este fin, se ha llevado a cabo un estudio comparativo entre dos regiones europeas que revela similitudes y diferencias desde el punto de vista jurídico y social. Se han seleccionado dos regiones: las penínsulas española e italiana, que comparten raices y culturas, asi como tradiciones similares por sus características comunes. Para limitar el campo del estudio, se realizó un estudio de caso en cada una de las dos regiones: la Comunidad Autónoma de La Rioja y la Región de Cerdeña, y en particular las ciudades de Logroño y Sassari, que son fácilmente comparables en cuanto a tamaño y características sociodemográficas. Como se han comparado dos sistemas que nacieron y se desarrollaron en condiciones históricas, jurídicas y sociales muy diferentes, se ha considerado indispensable encuadrar, en primer lugar, los dos sistemas de salud desde el punto de vista histórico y jurídico. Se ha dedicado el primer capítulo al análisis de concepto de salud desde una perspectiva histórica y legal. Se han examinado los determinantes de salud a lo largo de la historia para comprender el debate sobre la primacía de los factores individuales sobre los de la población o viceversa, como sucedió durante la pandemia. Luego se ha investigado la compleja naturaleza del derecho a la salud y su fundamentación filosófico-jurídica como derecho social protegido, tanto por las normas internacionales como por las leyes de España e Italia. Además, considerando que ambos países tienen un sistema sanitario descentralizado, se ha intentado profundizar el estudio sus Sistemas Sanitarios a nivel territorial. Como para estudiar un fenómeno es buena práctica acercarse al territorio para comprender qué tipo de cobertura sanitaria ofrecen estos países, el trabajo se ha adentrado en el análisis de dos realidades territoriales (La Rioja y Cerdeña) mirándolos desde el punto de vista práctico. Se han analizado los servicios sanitarios y sociales ofrecidos por ambos Sistemas, siempre teniendo en cuenta la variedad y diferencias entre sus estatutos. Además, para comprobar si los sistemas de salud responden a las necesidades de falta de salud del usuario y cuál es el nivel de satisfacción del ciudadano por los servicios sanitarios en las dos realidades territoriales, se ha realizado una encuesta que, recogiendo las opiniones de la ciudadanía, ha puesto de relieve los matices y rasgos de ambos sistemas. Por último, a través de un esfuerzo de abstracción inductivo que permitiera pasar de una perspectiva particular a una visión general, se ha intentado ir más allá de la visión del solo individuo para obtener, inicialmente, una perspectiva objetiva y, luego, más general del fenómeno objeto de estudio. El fuerte impacto sobre los sistemas sanitarios causado por la crisis sanitaria de 2020 nos ha obligado a reconsiderar que la salud no puede entenderse sin enfermedad y sin prevención. En primer lugar, la sociedad ha envejecido y, por consiguiente, el contexto social es cambiado con respecto al pasado. Sin embargo, hay un aumento en el control de las enfermedades que se vuelven crónicas con una alta tasa de supervivencia y un marcado aumento en la esperanza de vida. Este contexto nos está haciendo repensar, no sólo una redefinición del concepto de salud, sino cómo reajustar las regulaciones y los propios sistemas de salud. Este análisis permite comprender, desde el punto de vista jurídico y social, sí los sistemas sanitarios de La Rioja y de Cerdeña siguen respondiendo a las necesidades sanitarias de la población o si algo ha cambiado. También quiere mostrar si el derecho a la salud, que es universalmente reconocido como un derecho humano por la comunidad internacional, se aplica y cómo se está implementando. En fin, nos permite comprender, desde un punto de vista más general, si el modelo del estado del bienestar aplicado en ambos países sigue siendo el mismo o ha cambiado después de 2020."],"dc:format":["application/pdf"],"dc:identifier":["https://dialnet.unirioja.es/servlet/oaites?codigo=404148"],"dc:language":["spa"],"dc:publisher":["Universidad de La Rioja (España)"],"dc:rights":["LICENCIA DE USO: Los documentos a texto completo incluidos en Dialnet son de acceso libre y propiedad de sus autores y/o editores. Por tanto, cualquier acto de reproducción, distribución, comunicación pública y/o transformación total o parcial requiere el consentimiento expreso y escrito de aquéllos. Cualquier enlace al texto completo de estos documentos deberá hacerse a través de la URL oficial de éstos en Dialnet. Más información: https://dialnet.unirioja.es/info/derechosOAI | INTELLECTUAL PROPERTY RIGHTS STATEMENT: Full text documents hosted by Dialnet are protected by copyright and/or related rights. This digital object is accessible without charge, but its use is subject to the licensing conditions set by its authors or editors. Unless expressly stated otherwise in the licensing conditions, you are free to linking, browsing, printing and making a copy for your own personal purposes. All other acts of reproduction and communication to the public are subject to the licensing conditions expressed by editors and authors and require consent from them. Any link to this document should be made using its official URL in Dialnet. More info: https://dialnet.unirioja.es/info/derechosOAI"],"dc:title":["Modelos de sistemas sanitarios en el contexto Mediterráneo: el caso de La Rioja y Cerdeña"],"dc:type":["text (thesis)"]},"updated_at":"2026-07-24T06:27:11Z"}