Il Servizio sanitario nazionale

Summary

The National Health Service (NHS) in Italy, established in 1978, guarantees universal health coverage based on the Italian Constitution, emphasizing health as a fundamental right. The NHS is financed mainly by public taxes and offers services under the principles of universality, equality, and comprehensiveness. Essential health services are provided free or with co-payments, with regional and local health authorities managing care. Over time, reforms such as the 1992, 1999, and 2012 changes have shaped the NHS, focusing on efficiency and regional equity while allowing private facilities to participate in the system.

Takeaways

• 😀 Article 32 of the Italian Constitution guarantees health as a fundamental right, emphasizing that it is an inviolable human right and a collective good.
• 😀 The National Health Service (NHS) was established in 1978 to ensure the physical and mental health of all citizens through public tax revenues.
• 😀 The NHS operates under four key principles: universality, equality, equity, and comprehensiveness, providing free care to all citizens, with some co-payments for specialist services.
• 😀 Essential Levels of Care (LEA) define the services necessary to meet the basic health needs of the population, provided free of charge or with co-payments.
• 😀 The LEA are periodically updated by the government to address emerging health needs, with planning carried out at national, regional, and local levels.
• 😀 The NHS is primarily funded by public resources, including regional revenues, taxes, and co-payments from users, with the state covering gaps when necessary.
• 😀 Local Health Authorities (ASLs) are responsible for delivering healthcare services at the local level, managing the territory and essential services.
• 😀 Hospital care is mainly provided by autonomous hospital companies, introduced as part of healthcare system reforms in 2015.
• 😀 A key reform in 1999 introduced the freedom of choice for users, allowing them to choose between public and private facilities, with private facilities meeting certain requirements to participate in the NHS.
• 😀 The corporatization of the NHS began with the 1992 reform, moving towards a model focused on efficiency, cost-effectiveness, and quality through local healthcare companies.

Q & A

What does Article 32 of the Italian Constitution state about health?

Article 32 of the Italian Constitution protects health as a fundamental right, both for individuals and the entire community. It emphasizes that no one can be forced into a specific health treatment unless required by law, and it must always respect the dignity of the person. It also guarantees free healthcare for the indigent and ensures equality in access to health services.

When was the National Health Service (NHS) established in Italy?

The National Health Service (NHS) in Italy was established in 1978.

What are the key principles that guide the National Health Service in Italy?

The guiding principles of the National Health Service in Italy are universality, equality, equity, and comprehensiveness. These principles ensure that healthcare services are available to all citizens, regardless of their social or economic status, and they focus on providing a person-centered approach to health care.

What is the role of the essential levels of care (LEA) in the Italian healthcare system?

The essential levels of care (LEA) refer to the healthcare services and benefits that meet the fundamental needs of all citizens. These services are guaranteed free of charge or with co-payments and are updated periodically to address emerging health needs. LEA ensures equitable access to necessary healthcare for everyone.

How is the National Health Service in Italy financed?

The National Health Service is primarily financed through public tax revenues, including regional taxes, user fees (co-payments), and the proceeds from regional tax activities. The state contributes to funding when regional resources are insufficient or to balance disparities between regions.

What is the structure of local health authorities (ASLs) in the Italian healthcare system?

Local health authorities (ASLs) are public structures responsible for providing healthcare to the population in specific territories. They ensure the provision of essential healthcare services and are divided into districts with a user base of approximately 60,000 people. Each ASL is managed by a general director appointed by the region.

What reforms in the 1990s helped transform Italy's National Health Service?

The Lorenzo reform of 1992 and the Bindi reform of 1999 were key in transforming Italy's National Health Service. These reforms shifted healthcare spending from being purely needs-based to also considering revenue generation. The reforms introduced a corporate-like model focusing on efficiency, cost-effectiveness, and quality, which led to the creation of local healthcare companies with more autonomy.

What does the corporatization of the National Health Service refer to?

The corporatization of the National Health Service refers to the shift from a purely government-funded system to a more corporate-style model. It emphasizes efficiency, cost-effectiveness, and quality, with healthcare activities being managed by local healthcare companies that have entrepreneurial autonomy. This shift was influenced by reforms in 1992 and 1999.

How does the freedom of choice between public and private facilities work in Italy’s healthcare system?

Since 1999, users in Italy have the freedom to choose between public and private healthcare facilities. Private facilities that meet specific structural and professional requirements can become contracted with the public system and offer services under the National Health Service.

What is the role of the regional and national health plans in Italy’s healthcare system?

The national health plan is formulated at the central level, while the regional health plan is created by each region’s government. Both plans focus on achieving health objectives through structured health planning at national, regional, and local levels. The local implementation plans are then developed by individual health authorities to ensure the effective delivery of healthcare services.