This paper discusses a reform recently implemented in the Italian National Health Service (INHS), aimed at adding some socio-economic indicators to the criteria adopted for allocating healthcare funding to Regions. The reform is based on international experience in healthcare financing in decentralized settings and provides a case study of special interest since Italy is a country with significant territorial disparities and severe budget constraints. The paper first discusses the long-standing debate between Italian Regions which led to the reform. Second, the main features of the reform are reviewed, with the inclusion of socio-economic indicators via a simplified formula. Moreover, a possible revision of the reform is proposed, fully exploiting, unlike now, the heterogeneity of health needs according to age and socio-economic indicators. By integrating the information on deprivation inside the mechanism, the weight of the different drivers is determined by the distribution of needs and not on a discretionary basis. Simulating the proposed revision suggests that more resources could be allocated to the Regions with higher levels of deprivation compared to a scenario that closely replicates the reform.
Fantozzi, R., Gabriele, S., Zanardi, A. (2025). The role of socio-economic determinants in the interregional allocation of healthcare resources: some insights from the 2023 reform in the Italian NHS. HEALTH POLICY, 152, 1-6 [10.1016/j.healthpol.2024.105240].
The role of socio-economic determinants in the interregional allocation of healthcare resources: some insights from the 2023 reform in the Italian NHS
Zanardi, Alberto
2025
Abstract
This paper discusses a reform recently implemented in the Italian National Health Service (INHS), aimed at adding some socio-economic indicators to the criteria adopted for allocating healthcare funding to Regions. The reform is based on international experience in healthcare financing in decentralized settings and provides a case study of special interest since Italy is a country with significant territorial disparities and severe budget constraints. The paper first discusses the long-standing debate between Italian Regions which led to the reform. Second, the main features of the reform are reviewed, with the inclusion of socio-economic indicators via a simplified formula. Moreover, a possible revision of the reform is proposed, fully exploiting, unlike now, the heterogeneity of health needs according to age and socio-economic indicators. By integrating the information on deprivation inside the mechanism, the weight of the different drivers is determined by the distribution of needs and not on a discretionary basis. Simulating the proposed revision suggests that more resources could be allocated to the Regions with higher levels of deprivation compared to a scenario that closely replicates the reform.File | Dimensione | Formato | |
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