In pursuing its efforts to make the healthcare system more sustainable, the government must reinforce its role in setting guidelines and monitoring regional healthcare systems in order to guarantee equal services at least in terms of basic care levels throughout the country and with them greater equality of care for all citizens.
The reform of Title V of the Constitution approved in 2001, that differentiates between exclusive and concurrent legislative competence of national and regional government, on the one hand made it possible for the regions to create healthcare systems “customized” to their individual situations, but on the other made the task of central government more difficult in assuring equal basic care levels throughout the country, exactly because of regional differences. In addition, public spending constraints, the on-going economic crisis and continued cuts in the healthcare sector are threatening the ability of the different systems to safeguard care to especially the weakest and most needy segments of the population.
The Meridiano Sanità Regional Index, created by The European House – Ambrosetti, is designed to provide a multidimensional assessment of regional healthcare systems through comparison of their performance, both between each other and in terms of the national average, and identify the areas of greatest discrepancy between the different regions. (Find here the full Meridiano Sanità Report).
The Index is based on a significant number of indicators—40 key performance indicators—that represent the different key aspects of regional healthcare systems. These have been grouped into four areas of analysis:
On the basis of analysis results, Emilia Romagna (7.3) and Lombardy (7.0) have the best performance levels, followed by Tuscany and Trentino Alto Adige with scores of 6.9. In comparison, all the regions in the south of Italy have scores below the national average.
There are areas of the study in which the regional discrepancies are more marked than others. The state of health of the population, which is still one of the best in Europe, also has the lowest discrepancy level, an indication that in comparison with the rest of Europe, all Italian regions score well.
In terms of equality and ability to respond to health needs—the area in which Italy is most penalized in comparison with other European countries—the level of discrepancy is the highest. This indicates that the national performance average is drastically lowered by the regions in southern Italy which, in terms of prevention, care of the elderly and chronic diseases, and equity of the system, must make a number of steps forward.
Putting together the healthcare expenditure of the regions—which indicates the amount of resources earmarked for such a fundamentally-important sector—with the performance levels registered in the Meridiano Sanità Regional Index, what emerges is that the regions with the best results are also those with a higher level of public and private expenditure. In addition, these regions, all in the north of Italy, are also richer regions. The results for regions in the south are the opposite, in other words, with worse performance and lower levels of public expenditure.
Partner, The European House - Ambrosetti