Panoramica della Basilica ed alcuni nuovi reparti del HSR

Italy's healthcare system is consistently ranked among the best in the world.

Life expectancy Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, current age, and other demographic factors like sex. The most commonly used measure is life expectancy at birth ...

is the 4th highest among

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countries (83.4 years in 2018) and the world's 8th highest according to the

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(82.8 years in 2018).

Healthcare Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...

spending accounted for 9.7% of GDP in 2020. The Italian state runs a universal public healthcare system since 1978. However, healthcare is provided to all citizens and residents by a mixed public-private system. The public part is the ''Servizio Sanitario Nazionale'', which is organised under the Ministry of Health and administered on a devolved regional basis.

History

After World War II, Italy re-established its social security system including a social health insurance administered by sickness funds and private insurances. In the 1970s the

social health insurance National health insurance (NHI), sometimes called statutory health insurance (SHI), is a system of health insurance that insures a national population against the costs of health care. It may be administered by the public sector, the private sect ...

faced severe equity problems as coverage differed between the sickness funds, around 7% of the population remained uninsured, especially in the South. Moreover, sickness funds went practically bankrupt by the mid-1970s. Due to growing public dissatisfaction with the existing healthcare system, Italian policymakers led by the Christian-Democrats instituted structural reform. In 1978, the government established the SSN (''Servizio Sanitario Nazionale'' or National Health Service) including universal coverage for the whole population financed through tax funding, while private health continued to exist but was reserved for those who were willing to pay for extra services or services not offered by the SSN, such as dentistry or psychology.

National Health Service

The National Health Service was created in 1978. Healthcare is provided to all citizens and residents by a mixed public-private system. The public part is the national health service, Servizio Sanitario Nazionale (SSN), which is organized under the Ministry of Health and is administered on a regional basis. Family doctors are entirely paid by the SSN, must offer visiting time at least five days a week and have a limit of 1500 patients. Patients can choose and change their GP, subjected to availability. Ospedale San Gerardo (Monza)-Interior

Prescription drug A prescription drug (also prescription medication or prescription medicine) is a pharmaceutical drug that legally requires a medical prescription to be dispensed. In contrast, over-the-counter drugs can be obtained without a prescription. The rea ...

s can be acquired only if prescribed by a doctor. If prescribed by the family doctor, they are generally subsidized, requiring only a

copay A copayment or copay (called a gap in Australian English) is a fixed amount for a covered service, paid by a patient to the provider of service before receiving the service. It may be defined in an insurance policy and paid by an insured person ea ...

that depends on the medicine type and on the patient income (in many regions all the prescribed drugs are free for the poor).

Over-the-counter drug Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a requirement for a prescription from a healthcare professional, as opposed to prescription drugs A prescription drug (also prescription medication or prescripti ...

s are paid out-of-pocket. Both prescription and over-the-counter drugs can only be sold in specialized shops (''farmacia''). In a sample of 13 developed countries, Italy was sixth in its population weighted usage of medication in 14 classes in 2009 and fifth in 2013. The drugs studied were selected on the basis that the conditions treated had a high incidence, prevalence and/or mortality, caused significant long-term morbidity and incurred high levels of expenditure and significant developments in prevention or treatment had been made in the last 10 years. The study noted considerable difficulties in cross-border comparison of medication use. Visits by specialist doctors or

diagnostic test A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic ...

s are provided by the public hospitals or by private ones with contracts to provide services through the national health service, and if prescribed by the family doctor require only a

(of the order of $40 for a visit without any diagnostic test) and are free for the poor. Waiting times are usually up to a few months in the big public facilities and up to a few weeks in the small private facilities with contracts to provide services through the national health service, though the referring doctor can shorten the waiting times of the more urgent cases by prioritising them. Total health expenditure as a Percentage of GDP (2005-2008)

Total health expenditure as a Percentage of GDP (2005-2008)

Performance

Surgeries and hospitalization provided by public hospitals or by conventioned private ones are completely free of charge for everyone, regardless of their income. For planned surgery waiting times can be up to many months, especially in the big cities. The Italian National Outcomes Programme permits measurement of variation in the quality and outcomes of care by region, which is very considerable. So, for example, the proportion of patients receiving coronary angioplasty within 48 hours of a heart attack varies from about 15% in some regions, such as

Marche Marche ( , ) is one of the twenty regions of Italy. In English, the region is sometimes referred to as The Marches ( ). The region is located in the central area of the country, bordered by Emilia-Romagna and the republic of San Marino to the ...

Molise Molise (, , ; nap, label=Neapolitan language, Neapolitan, Mulise) is a Regions of Italy, region of Southern Italy. Until 1963, it formed part of the region of Abruzzi e Molise, alongside the region of Abruzzo. The split, which did not become effe ...

and

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to nearly 50% in the northern regions Valle d’Aosta and

Liguria Liguria (; lij, Ligûria ; french: Ligurie) is a Regions of Italy, region of north-western Italy; its Capital city, capital is Genoa. Its territory is crossed by the Alps and the Apennine Mountains, Apennines Mountain chain, mountain range and is ...

. Measured at Local Health Authority level the levels varied between 5% and more than 60%. This geographic variability was the greatest of any of the 11 countries studied by the OECD. There is evidence of internal patient movement probably driven by a search for better quality care generally from the poorer and less developed southern regions to the more prosperous north.

Emergency medicine

The

emergency medical services in Italy Emergency medical services in Italy currently consist primarily of a combination of volunteer organizations providing ambulance service, supplemented by physicians and nurses who perform all advanced life support (ALS) procedures. The emergency tel ...

currently consist primarily of a combination of volunteers and private companies providing ambulance service, supplemented by physicians and nurses who perform all

Advanced Life Support Advanced Life Support (ALS) is a set of life saving protocols and skills that extend basic life support to further support the circulation and provide an open airway and adequate ventilation (breathing). Components These include: * Tracheal in ...

procedures. The primary

emergency telephone number Most public switched telephone networks have a single emergency telephone number (sometimes known as the universal emergency telephone number or the emergency services number) that allows a caller to contact local emergency services for assista ...

for emergency medical service in Italy is still 118, since the European emergency number (112) doesn't work in many regions yet. Emergency medical service is always free of charge. First aid is provided by all the public hospitals: for urgent cases it is completely free of charge for everyone (even for an undocumented

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), while a copay (about $35) is sometimes asked for non-urgent cases.

References

External links