Organization of medical services for the Winter Olympic Games:the Milano-Cortina 2026 case

The Milano-Cortina 2026 Winter Olympics represent a paradigmatic case of a widespread Olympics, with alpine and metropolitan clusters that transform medical services from a system centered on a single area into a multijurisdictional network. This narrative-comparative study analyzes the contemporary evolution of Olympic health management models (2006-2026) and contextualizes the Milano-Cortina plan through a literature review and documentary analysis of official reports from past editions, bid dossiers, and International Olympic Committee strategic documents. The results show a transition from host-city models to host-region arrangements, with a progressive increase in governance requirements, standardization, and informational interoperability. In the Milano-Cortina case, the multi-cluster architecture, the dualism between closed-loop pathways and care for the general population, and the integration with emergency care and public health further increase organizational complexity. Consistent with Winter Games surveillance showing sport-specific injury variability and a non-negligible illness burden, internal medicine—alongside emergency care—emerges as a stabilizing component for non-traumatic conditions and comorbidities. The model's effectiveness will depend on centralized oversight, interregional coordination, and monitoring mechanisms to ensure continuity of care and territorial equity.