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How health care regionalisation in Italy is widening the North–South gap

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  • Toth, Federico

Abstract

The Italian National Health Service began experimenting with a significant regionalisation process during the 1990s. The purpose of this article is to assess the effects that this regionalisation process is having on the rift between the north and the south of the country. Has the gap between the health care systems of the northern and southern regions been increasing or decreasing during the 1999–2009 decade? Three indicators will be utilised to answer this question: (1) the level of satisfaction expressed by the citizens towards the regional hospital system; (2) the mobility of the patients among regions; (3) the health care deficit accumulated by the individual regions. On the basis of these three indicators, there is evidence to conclude that, during the decade under study, the gap between the North and the South, already significant, has increased further.

Suggested Citation

  • Toth, Federico, 2014. "How health care regionalisation in Italy is widening the North–South gap," Health Economics, Policy and Law, Cambridge University Press, vol. 9(3), pages 231-249, July.
    • Handle: RePEc:cup:hecopl:v:9:y:2014:i:03:p:231-249_00
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    Cited by:

    1. Livio Garattini & Alessandro Curto & Nick Freemantle, 2016. "Access to primary care in Italy: time for a shake-up?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(2), pages 113-116, March.
    2. Mauro, Marianna & Giancotti, Monica, 2023. "The 2022 primary care reform in Italy: Improving continuity and reducing regional disparities?," Health Policy, Elsevier, vol. 135(C).
    3. Alessandra Cepparulo & Luisa Giuriato, 2022. "The residential healthcare for the elderly in Italy: some considerations for post-COVID-19 policies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(4), pages 671-685, June.
    4. Nicola Giannelli & Andrea Lippi, 2022. "The relevance of non-institutional practice in health care steering at local level in Italy.What has been learnt in pandemic times?," Working Papers 2203, University of Urbino Carlo Bo, Department of Economics, Society & Politics - Scientific Committee - L. Stefanini & G. Travaglini, revised 2022.
    5. Cristina Civilotti & Sabrina Berlanda & Laura Iozzino, 2021. "Hospital-Based Healthcare Workers Victims of Workplace Violence in Italy: A Scoping Review," IJERPH, MDPI, vol. 18(11), pages 1-17, May.
    6. Vincenzo Carrieri & Maria De Paola & Francesca Gioia, 2021. "The health-economy trade-off during the Covid-19 pandemic: Communication matters," PLOS ONE, Public Library of Science, vol. 16(9), pages 1-25, September.
    7. Gabriella Berloffa & Francesca Paolini, 2019. "Decomposing Immigrant Differences in Physical and Mental Health: A 'Beyond the Mean' Analysis," DEM Working Papers 2019/4, Department of Economics and Management.
    8. Cavazza, Marianna & Vecchio, Mario Del & Fattore, Giovanni & Fenech, Lorenzo, 2023. "Geographical variation in the use of private health insurance in a predominantly publicly-funded system," Health Policy, Elsevier, vol. 130(C).
    9. Di Novi, Cinzia & Piacenza, Massimiliano & Robone, Silvana & Turati, Gilberto, 2019. "Does fiscal decentralization affect regional disparities in health? Quasi-experimental evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 78(C).
    10. Alexander Karpov, 2016. "Health care inequality, patient mobility and welfare," Economics Bulletin, AccessEcon, vol. 36(2), pages 1000-1009.
    11. Andrea Ciarini & Stefano Neri, 2021. "‘Intended’ and ‘unintended’ consequences of the privatisation of health and social care systems in Italy in light of the pandemic," Transfer: European Review of Labour and Research, , vol. 27(3), pages 303-317, August.
    12. Cavalieri, Marina & Ferrante, Livio, 2016. "Does fiscal decentralization improve health outcomes? Evidence from infant mortality in Italy," Social Science & Medicine, Elsevier, vol. 164(C), pages 74-88.
    13. Gabriella Berloffa & Francesca Paolini, 2022. "Going "beyond the mean" in analysing immigrant health disparities," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 47(7), pages 161-198.
    14. Di Novi, C. & Piacenza, M. & Robone, S. & Turati, G., 2015. "How does fiscal decentralization affect within-regional disparities in well-being? Evidence from health inequalities in Italy," Health, Econometrics and Data Group (HEDG) Working Papers 15/23, HEDG, c/o Department of Economics, University of York.
    15. Antonio Nuzzo & Flavia Carle & Eugenio Anessi Pessina, 2018. "Processo di decentramento del SSN ed evoluzione dell?equit? interregionale nell?assistenza sanitaria nel periodo 2001-2012," MECOSAN, FrancoAngeli Editore, vol. 2018(108), pages 9-34.
    16. Silvia Bruzzi & Enrico Ivaldi & Marta Santagata, 2022. "Measuring Regional Performance in the Italian NHS: Are Disparities Decreasing?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 159(3), pages 1057-1084, February.
    17. Noto, Guido & Belardi, Paolo & Vainieri, Milena, 2020. "Unintended consequences of expenditure targets on resource allocation in health systems," Health Policy, Elsevier, vol. 124(4), pages 462-469.

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