Health&Hospitals in Italy

Ermeneia, Aiop

Health&Hospitals in Italy

20th Annual report 2022

The «Health & Hospitals» Report offers annual monitoring and assessment of the effectiveness and efficiency of the Italian hospital system, recognizable by its mixed nature, comprising a public component and a private component. The Report has accompanied the National Health Service over the past 20 years of its 44-year lifespan, offering an updated, reasoned analysis based on objective data, ensuring the «third-party nature» of the evaluation, thanks to its being entrusted to an external, autonomous and independent entity, and adopting a dual-assessment perspective that takes into account both the point of view of demand (i.e. users and their healthcare needs) and the point of view of supply (i.e. the healthcare «machine» and its evolution over time)

Pages: 254

ISBN: 9788835154457

Edizione:1a edizione 2023

Publisher code: 10035.16

Info about Open Access books

The "Health & Hospitals" Report, in its 20th edition, offers annual monitoring and assessment of the effectiveness and efficiency of the Italian hospital system, recognizable by its mixed nature, comprising a public component and a private component. It is a hospital "machine" that makes a total of 185,000 beds available, of which 129,000 belong to public facilities and 56,000 to accredited facilities, which handled around 8 million inpatient stays per year up until the pandemic hit, dropping down to 6.4 million in 2020 in light of the need to prioritize the Covid-19 emergency.
Despite the decrease in services, especially regular services, due to the pandemic, the National Health Service still provided more than 48 million days of hospitalization, of which 71.7% were in public hospitals and 28.3% in private hospitals. The related public hospital expenditure in 2020 totaled EUR 69.3 billion, representing 56.2% of total public healthcare spending.
The Report has accompanied the National Health Service over the past 20 years of its 44-year lifespan, offering an updated, reasoned analysis based on objective data, ensuring the "third-party nature" of the evaluation, thanks to its being entrusted to an external, autonomous and independent entity, and adopting a dual-assessment perspective that takes into account both the point of view of demand (i.e. users and their healthcare needs) and the point of view of supply (i.e. the healthcare "machine" and its evolution over time).
In the hopes that the 2022 edition represents the closure of the complex three-year period of the pandemic, we wanted to describe this unprecedented interval, the more or less direct effects of which are destined to linger for a long time to come: the extraordinary emergency phase, dealt with in the year 2020; the proactive phase of 2021, characterized by the vast vaccination program and also by the interruption and postponement of services; and, finally, that of the year 2022, in which we found ourselves facing an aggravated phenomenon of postponed or as yet not provided services.
The Report demonstrates a significant increase in the phenomenon of waiting times and unsatisfied demand both through the analysis of current information flows and by means of a survey addressed to users of the NHS, with or without experience of the virus: the consequences are the "reactivity" - manifested essentially in the use of individual professionals and purely private services and the intramoenia services offered by public hospitals - but also the "passivity" of those who were forced to forgo treatment.
Out-of-pocket spending, which has always been a thorn in the side of our National Health Service, not only fails to be reabsorbed, but risks expanding even further, exacerbating inequities on a socio-economic basis between those who can and those who cannot afford it.
A common effort is increasingly necessary, the development of more convinced and transparent "purpose-driven alliances" between the public and private sectors in the NHS, implementing the positive collaboration experienced in the first year of Covid, to respond to the challenges posed by the "extraordinary" pandemic and to the by-now structural critical issues of a "regular system" called upon to renew itself.

Ermeneia - Studi & Strategie di Sistema (System Studies & Strategies) 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 private hospitals that are part of the National Health Service and private healthcare facilities located throughout all Italian Regions, which employ more than 73,000 workers and, accounting for 11% of the operators in the entire system, provide for the healthcare needs of 15% of patients.

Notes
Barbara Cittadini, Introduction
Part One. Why "Special Needs" Care Must Now be part of our "Regular Concerns"
Twenty years as the watchful eye of the Italian hospital system
(The basic rationale and aims of the Report; Four large reporting cycles; An ever-increasing need to stay vigilant)
The value of a system capable of improving the complexity of the services it provides, even in the year 2020, though not the results
(The structural profile of the time-tested mixed system of public and private hospitals; A constant increase in the average complexity of the services; The pandemic interruption in the positive trend of the results of the services provided)
A gradual interweaving of the backlog of services yet to be provided for inpatient and former Covid patients
(A rapid buildup of waiting lists by people who experienced the virus; A pronounced (and prolonged) number of interrupted/postponed regular services for both categories of patients; The (somewhat complicit) choices to interrupt/postpone services and the different reaction capacities of the healthcare facilities; Renewed "reactive behavior" by the public)
A unified strategy to restore services in both public facilities and private facilities
(The need to address the issue of a medium-term investment in healthcare and the mixed hospital system; The effects of the intertwining of the "special needs" and "regular concerns" on the Income Statements of public Hospital Centers as seen through the usual annual monitoring)
Part Two. Statistical Indicators
Facility data
(The presence of the public and private component institutions of the National Health Service; Bed distribution; Medical equipment)
Activity data
(In-hospital days and patient bed occupancy rate; Types of admissions and discharges; Prevalent DRGs; Activities classified according to major diagnostic categories; Activities classified according to specialty; The initiation of a process of measuring waiting times for services; The Long Covid of the National Health Service; Patient mobility)
Staff information
(Staff fluctuation over the years; The situation of employees by territory and professional category)
Spending data
(Economic flow trends over the years; Health expenditure comparisons)
Appendices
Methods applied
The complete list of contents of the 2022 Report.

Contributors: Barbara Cittadini

Serie: Aiop - Associazione italiana ospedalità privata - Open Access

Subjects: Medicine, Health

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