Health&Hospitals in Italy

19ht Annual report 2021


Ermeneia – Studi & Strategie di Sistema (ed)
AIOP – Associazione Italiana Ospedalità Privata (ed)


The “Health&Hospitals” Report provides an annual overview and interpretation of the performance of the Italian hospital system. Regulated partly by public law and partly by private law, the system as a whole is conceived as a mixed public-private system and is recognized and governed by the Legislative Decree 502, issued in 1992.
With a total of 187 thousand patient beds (131 thousand in public hospitals and 56 thousand in private accredited hospitals), Italy’s hospital system handles 8 million admissions per year, resulting in 57.5 million in-hospital days overall. Public expenditure of 65.9 billion Euros is paid into the system, accounting for 56.3% of public health spending as a whole.
From the outset, the Report opted to focus on two aspects most, analyzed by the third-party organization independently conducting the surveys: the first aspect concerns the dynamics (whether positive or problematic) affecting hospital services, whilst the second examines the opinions and feedback of citizens and users in relation to the above services.
In 2021, hospital and local health systems were forced to handle two tension factors. The first concerns the quantitative and qualitative disparities (neither of which is new) between services delivered to people living in different territories. As a result, 21 Regional Health Services were formed as opposed to a single, relatively uniform National Health Service: a phenomena that have started well before the onset of the Covid-19 pandemic. The second tension factor (a recent event) concerns all the problems involved in striking a balance between the services delivered to infected people and those delivered (or yet to be delivered) to ordinary patients: the latter have suffered as a result of the backlog in cancelled/postponed treatments from 2020 and subsequently 2021, whilst the fourth wave of the pandemic generated a further burden for hospital admissions, particularly amongst the unvaccinated.
This year, two separate surveys have been conducted: the first one focuses in an unprecedented way on those people who have been infected and have since recovered (albeit in many cases with problems linked to long Covid), while the second one has the goal to evaluate the indirect impact the pandemic has had on non-Covid patients who, for two consecutive years, have suffered cancellations or delays to treatments, with inevitable knock-on consequences in terms of their current and future state of health.
Since 2020, this two-fold emergency helped foster greater cooperation between public and private accredited hospital facilities, enhancing ways in which the latter could work alongside the former. This has opened up the way to a potential Alliance, which will hopefully make it possible to catch up on the backlog of services for those non-Covid patients currently on a waiting list, a category that has increased due to the pandemic.
But it is equally important to promote this Alliance in order to cover the many areas shared by both types of medical facilities. Only together, they can face the review of the hospital system, considered as part of a broader effort in protecting and promoting health. After the deeply-felt effects of the spending review, the aim should be to restore a funding level in line with other OECD countries and to wisely invest the resources from the national recovery plan (PNRR): all this will breathe new life into the National Health Service making it more in touch with patient needs and, at the same time, more efficient when it comes to managing its resources.


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Author Biographies

Ermeneia – Studi & Strategie di Sistema

It is a company that specializes in providing analytical and consulting activities to trade associations and public and private clients, including those operating in the healthcare service sector, who are actively redesigning their presence and operational methods to remain in step with progressive changes in Italy.

AIOP – Associazione Italiana Ospedalità Privata

Italian Association of Private Hospitals is a trade association that represents hospital facilities of the privately-operated component of the NHS and private healthcare facilities, throughout every region of Italy, which employ just over 72,000, accounting for 11% of the operators of the entire system, who provide hospital services to 15% of patients.


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July 15, 2022

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