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Explanation: I think that Azienda was tacked onto USL to give it the sense of a business; it is an azienda, not a struttura di beneficenza.
This is a very superficial explanation I am sure that there are reams of legal texts to explain it.
Explanation: Azienda Ospedialiera is the Hospital as a Company; Presidio Ospedaliero is the working staff of the Hospital (garrison hospital worker); USL is the Organization who controls the national health insurance, Hospitals and local services.