La Sanità in Italia: Il Difficile Equilibrio Tra Vincoli Di Bilancio E Qualità Dei Servizi Nelle Regioni in Piano Di Rientro (The Italian Healthcare System: The Difficult Balance between Budget Sustainability and the Quality of Services in Regions Subject to a Financial Recovery Plan)

102 Pages Posted: 20 Apr 2018

Date Written: March 28, 2018

Abstract

Italian Abstract: Il lavoro analizza le diverse fasi che hanno portato all’adozione dei Piani di Rientro in ambito sanitario e il loro successivo sviluppo. Si evidenziano gli interventi effettuati dalle otto Regioni obbligate a transitare per un Piano di Rientro e le implicazioni di tali interventi in termini di dotazioni infrastrutturali. Si confronta altresì l’evoluzione della qualità e dei tempi di attesa delle prestazioni, nonché della mobilità dei pazienti, anche comparativamente con le restanti Regioni. Il risanamento finanziario rimane incompleto: a fronte del suo sostanziale conseguimento in Piemonte, Sicilia e Campania, permangono disavanzi, anche significativi, in Lazio, Molise e Calabria. Ancor meno diffuso è il miglioramento della qualità delle prestazioni: pur in un quadro di generale miglioramento, solo il Piemonte è riuscito a garantire, in modo stabile, il pieno rispetto dei Livelli essenziali di assistenza (LEA), ancora mai raggiunti in Calabria e Campania.

English Abstract: In this work we analyse the developments that necessitated the adoption of Financial Recovery Plans (Piani di Rientro) for the healthcare systems of some Italian regions and how these plans evolved over time. We look at the measures adopted by the eight Italian regions that were obliged to adopt a Financial Recovery Plan as well as their implications for healthcare infrastructures. We examine service quality and waiting times as well as patient mobility in the eight regions, including by comparison with Italy’s other regions. Our results show that the plans achieved mixed economic results: they were effective in nudging Piedmont, Sicily and Campania towards a balanced budget, but Lazio, Molise and Calabria still suffer from deficits, even substantial ones. The improvement in service quality was even more mixed. While quality did improve in all the regions that adopted a plan, only Piedmont was able to guarantee the national minimum standard of service quality over time, while Calabria and Campania were never able to meet this standard.

Note: Downloadable document is in Italian.

Keywords: public health care system, Piani di Rientro, financial costs, patient mobility, quality of servicies

JEL Classification: H75, I18

Suggested Citation

Aimone Gigio, Luciana and Alampi, Demetrio and Camussi, Silvia Annamaria and Ciaccio, Giuseppe and Guaitini, Paolo and Lozzi, Maurizio and Mancini, Anna Laura and Panicara, Eugenia and Paolicelli, Massimiliano, La Sanità in Italia: Il Difficile Equilibrio Tra Vincoli Di Bilancio E Qualità Dei Servizi Nelle Regioni in Piano Di Rientro (The Italian Healthcare System: The Difficult Balance between Budget Sustainability and the Quality of Services in Regions Subject to a Financial Recovery Plan) (March 28, 2018). Bank of Italy Occasional Paper No. 427. Available at SSRN: https://ssrn.com/abstract=3165395 or http://dx.doi.org/10.2139/ssrn.3165395

Luciana Aimone Gigio (Contact Author)

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

Demetrio Alampi

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

Silvia Annamaria Camussi

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

Giuseppe Ciaccio

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

Paolo Guaitini

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

Maurizio Lozzi

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

Anna Laura Mancini

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

Eugenia Panicara

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

Massimiliano Paolicelli

Bank of Italy ( email )

Via Nazionale 91
Rome, 00184
Italy

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