Equity and efficiency in Italian health care
作者:
Pierella Paci,
Adam Wagstaff,
期刊:
Health Economics
(WILEY Available online 1993)
卷期:
Volume 2,
issue 1
页码: 15-29
ISSN:1057-9230
年代: 1993
DOI:10.1002/hec.4730020104
出版商: Wiley Subscription Services, Inc., A Wiley Company
关键词: Equity;efficiency;Italy;social insurance;health care finance
数据来源: WILEY
摘要:
AbstractHealth care finance and provision in Italy is unusual by international standards: public financing relies heavily on both general taxation and social insurance, and although the vast majority of expenditure is publicly financed, the majority of care is provided by the private sector. The system suffers, however, from a chronic failure to control expenditures and its record on perinatal and infant mortality is poor. Hospitals in Italy have a low bed‐occupancy rate by international standards and the per diem system of reimbursing private hospitals encourages unduly long stays. Costs per inpatient day are high by international standards, but costs per admission are close to the OECD average. Ambulatory care costs are extremely low, but this appears to be due to the fact that GPs see so many patients that their role is inevitably mainly administrative. Consumption of medicines is extremely high, but because the cost per item is low, expenditure per capita is not unduly high. Despite the emphasis on social insurance, the financing system appears to be progressive. There is evidence of inequalities in health in Italy, and some evidence that health care is not provided equally to those in the same degree of nee
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