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Demand and supply of hospital services. International trends


  • Giovanni Iuzzolino

    () (Banca d'Italia)


This paper describes the main international trends in the demand for and supply and cost of hospital services in the last decades. In almost all countries, including Italy, there has been a substantial reduction in the total length of hospitalizations, a steady rise in the use of day-hospitals and a widespread reduction in the number and capacity of hospitals. These trends have been reinforced by reforms in payment systems and in particular by the use of case payments for reimbursing hospitals. By international standards, the Italian hospital system is characterized by relatively high fragmentation, a situation partly related to the weakness of nursing and residential care facilities in Italy, with an unbalanced "division of labour" between in-patient and out-patient care. This has consequences both for the unit costs of hospitalization and for the hospital component’s share of total health expenditure (in Italy above the OECD average). The higher cost of hospital services is also a reflection of the composition of hospital staff, which is strongly biased towards the medical component, especially in small hospitals.

Suggested Citation

  • Giovanni Iuzzolino, 2008. "Demand and supply of hospital services. International trends," Questioni di Economia e Finanza (Occasional Papers) 27, Bank of Italy, Economic Research and International Relations Area.
  • Handle: RePEc:bdi:opques:qef_27_08

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    References listed on IDEAS

    1. Massimo Filippini & Diego Lunati & Luca Crivelli, 2001. "Dimensione ottima degli ospedali in uno Stato federale," ECONOMIA PUBBLICA, FrancoAngeli Editore, vol. 2001(5).
    2. Jonas Schreyögg & Tom Stargardt & Oliver Tiemann & Reinhard Busse, 2006. "Methods to determine reimbursement rates for diagnosis related groups (DRG): A comparison of nine European countries," Health Care Management Science, Springer, vol. 9(3), pages 215-223, August.
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    More about this item


    hospital services; health expenditure;

    JEL classification:

    • H44 - Public Economics - - Publicly Provided Goods - - - Publicly Provided Goods: Mixed Markets
    • I10 - Health, Education, and Welfare - - Health - - - General

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