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The Italian health-care system

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Author Info

  • George France

    (Istituto di Studi sui Sistemi Regionali e Federali e sulle Autonomie, Consiglio Nazionale delle Ricerche, Rome, Italy)

  • Francesco Taroni
  • Andrea Donatini

    (Agenzia Sanitaria Regionale, Regione Emilia-Romagna, Bologna, Italy)

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    Abstract

    Italy's national health service is statutorily required to guarantee the uniform provision of comprehensive care throughout the country. However, this is complicated by the fact that, constitutionally, responsibility for healthcare is shared between the central government and the 20 regions. There are large and growing differences in regional health service organisation and provision. Public health-care expenditure has absorbed a relatively low share of gross domestic product, although in the last 25 years it has consistently exceeded central government forecasts. Changes in payment systems, particularly for hospital care, have helped to encourage organisational appropriateness and may have contributed to containing expenditure. Tax sources used to finance the Servizio Sanitario Nazionale (SSN) have become somewhat more regressive. The limited evidence on vertical equity suggests that the SSN ensures equal access to primary care but lower income groups face barriers to specialist care. The health status of Italians has improved and compares favourably with that in other countries, although regional disparities persist. Copyright © 2005 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.1035
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    Bibliographic Info

    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 14 (2005)
    Issue (Month): S1 ()
    Pages: S187-S202

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    Handle: RePEc:wly:hlthec:v:14:y:2005:i:s1:p:s187-s202

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. Eddy van Doorslaer & Xander Koolman, 2004. "Explaining the differences in income-related health inequalities across European countries," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 609-628.
    2. Fattore, Giovanni & Jommi, Claudio, 1998. "The new pharmaceutical policy in Italy," Health Policy, Elsevier, vol. 46(1), pages 21-41, October.
    3. Vincenzo Atella & Francesco Brindisi & Partha Deb & Furio C. Rosati, 2003. "Determinants of Access to Physician Services in Italy: A Latent Class Seemingly Unrelated Probit Approach," CEIS Research Paper 36, Tor Vergata University, CEIS.
    4. Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
    5. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
    6. Ghislandi, Simone & Krulichova, Iva & Garattini, Livio, 2005. "Pharmaceutical policy in Italy: towards a structural change?," Health Policy, Elsevier, vol. 72(1), pages 53-63, April.
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