Health Systems in Transition - Italy Health System Review

The HiT profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, fi nancing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis. Various indicators show that the health of the Italian population has improved over the last few decades. Average life expectancy reached 77.6 years for men and 83.2 years for women in 2005, and the mortality rate among adults has fallen signifi cantly, as has the infant mortality rate. However, in almost all demographic and health indicators, there are marked regional differences for both men and women, refl ecting the economic imbalance between the north and south of the country. The main diseases affecting the population are circulatory diseases, malignant tumours and respiratory diseases, while smoking and rising obesity levels, particularly among young people, remain important public health challenges. Italy’s health care system is a regionally based National Health Service (Servizio Sanitario Nazionale (SSN)) that provides universal coverage free of charge at the point of service. The national level is responsible for ensuring the general objectives and fundamental principles of the national health care system. Regional governments, through the regional health departments, are responsible for ensuring the delivery of a benefi ts package through a network of population-based health management organizations and public and private accredited hospitals. Again, there is a considerable north–south divide in the quality of health care facilities and services provided to the population, and there are signifi cant cross-regional patient fl ows, particularly to receive high-level care