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Abstract Chapter 6

Chapter 6 provides, as usual, an updated overview of the trends and determinants of private healthcare consumption in Italy. Private healthcare expenditure amounts to 26% of total expenditure, mainly in the form of out-of-pocket spending (24%). This proportion is slightly higher than in the other countries with universalistic vocation, while the out-of-pocket expenditure per capita in current euro is in line, if not lower, to other European countries. In terms of public spending per capita and intermediate per capita expenditure, our country shows significantly, lower values ​​than other European countries. The estimate of private healthcare spending may vary between € 27.5 billion and € 49.5 billion, depending on the items of expenditure and the various subjects and funding schemes considered. The central value is that provided by national and international bodies, which show how the health expenditure of Italian families amounts to about 40 billion euro, distributed between goods (35%) and services (65%). At regional level, the health expenditure of families shows significant variations: the average per capita expenditure goes from around € 330 in Campania to more than € 800 in Lombardy and € 950 in Valle d'Aosta. This dynamic shows how there is a positive relationship between health expenditure and per capita income. Therefore, the relationship also emerges with the quality of regional systems: the regions with the lowest per capita private spending are the same ones that suffer the most in terms of variables that measure the quality of services provided by the SSR. A more in-depth analysis of the socio-economic characteristics allowed, finally, to begin to characterize the relationship between health expenditure, general expenditure and family income, trying to observe the presence of any regressive effects that this may have on weaker socio-economic classes.