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Abstract Chapter 5

Chapter 5 illustrates data on INHS funding, health expenditure and operating results by Italian Regions and Autonomous Provinces, presenting the state of progress of the Recovery Plans and the measures to cover previous healthcare deficits. This chapter shows that public healthcare expenditure has stabilized over the last 7 years, increasing by an average growth rate of 0.7% compared to 2010. In 2016, in particular, it increased by 1.1% over 2015, reaching a value of about 115.8 billion Euros. The harmonization of the reporting system for additional resources derived from regional direct tax allows a global accounting surplus of € 329 million, confirming the system's ability to maintain an overall economic and financial equilibrium. The increase of total healthcare expenditure compared to the previous year is due to growth in goods and services (+2.5%), contractual specialty care (+1.1%) and other contractual assistance (+2.6%).

However, overall stability is accompanied by a significant heterogeneity at the regional level in relation to the variability of healthcare expenditure and its impact on regional GDP. Nevertheless, regional variation in per capita public healthcare expenditure is declining, indicating that the cost of assistance is slowly homogenizing. This trend is even more visible if mobility is taken into account, testifying that the real demand for healthcare services is not so variable between regions. On the contrary, variability in the incidence of public healthcare expenditure on regional GDP is increasing. This evidence highlights the contrast between a system that tends to standardize cost functions and, on the other side, self-finances by local economic systems that are increasingly different from each other.