Abstract Chapter 8

Chapter 8 provides an overview of recent trends and drivers of private healthcare consumption in Italy. Along with other universal healthcare systems, in Italy private healthcare expenditure makes up 25% of total healthcare expenditure, mainly in the form of household out-of-pocket (OOP) payments (23%). Recent estimates from the OCPS (Observatory on Private Healthcare Consumption) show that household healthcare OOP expenditure amounts to about 39 billion euros, evenly distributed between goods (46%) and services (54%). The first component is mostly related to the purchase of pharmaceutical products (8.4 billion Euros) while the latter includes a basket of items, including dental care (9 billion Euros), outpatient services (7 billion Euros) and hospital services (1.4 billion Euros). At a regional level, household healthcare expenditure shows notable variation. Per capita values range from less than 300 Euros in Campania to more than 700 Euros in Lombardy. This pattern confirms that there is a positive association between healthcare expenditure per capita and income per capita. However, it also suggests that regional distribution may be positively associated with the quality of regional systems: low-spending regions are also at the bottom of regional public healthcare rankings and vice versa. Besides income and the quality of public systems, other socio-demographic factors should be considered. What makes private healthcare consumption interesting is not only the limits on the growth of public expenditure, but also that public and private consumption are increasingly interdependent. Phenomena such as an ageing population, the prevalence of chronic conditions, the modification of individual attitudes and behaviors towards health, are transforming the consumption of healthcare from an episodic to a more continuous and systematic experience, in which individuals use and connect all available resources (public and private) to satisfy their perceived needs.