Istat/ Bes Report: winds of crisis in the NHS but life expectancy rises to 83.1 years in 2023 | Healthcare24

As of 31 December, life expectancy “is equal to 83.1 years, an increase compared to 2022 (82.3)”, almost completely recovering the 2019 level (83.2 years): “Men with 81.1 years of expected average life return to the same level as in 2019, for women (85.2 years) there are still 0.2 years to go (85.4 in 2019)”. This was revealed by the Istat Report on Fair and Sustainable Wellbeing (Bes). “Life expectancy in good health in 2023 is equal to 59.2 years and is reduced compared to 60.1 years in 2022, bringing the indicator almost back to the 2019 level (58.6 years)”, indicates Istat . In 2021, “the cancer mortality rate of the adult population aged 20-64 is 7.8 per 10,000 residents and has decreased compared to 2020 (8 per 10,000 residents). Socio-economic inequalities are also observed in cancer mortality among the adult population, with a disadvantage that increases as the level of education decreases; they are more marked in males, where the less educated individuals have a mortality rate 2.1 times higher than the more educated ones, in females this ratio drops to 1.4”.

The Report, however, also indicates that in 2023 approximately 4.5 million citizens had to give up medical visits or diagnostic tests due to economic problems, waiting lists or access difficulties, 7.6% of the population: up compared to 7% in 2022 and 6.3% in 2019, probably due to the recovery of healthcare benefits deferred due to Covid-19 and difficulties in effectively reorganizing healthcare. There is a doubling of the share of those who gave up due to waiting list problems (from 2.8% in 2019 to 4.5% in 2023); the renunciation for economic reasons is stable (from 4.3% in 2019 to 4.2% in 2023), but still increasing compared to 2022: +1.3 percentage points in just one year.

Shortage of staff, disheartened citizens, hospital emigration are the signs that indicate the crisis of the Italian healthcare system. According to the Report, after the experience of the pandemic, the NHS must face a situation in which many general practitioners are close to leaving the job market (77% are over 54) with a workforce already in sharp decline (from 7 .5 per 10 thousand inhabitants in 2012 to 6.7 in 2022). The share of “maximalists”, i.e. general practitioners with more than 1,500 patients, has significantly increased (from 27.3% to 47.7%). The system also has, and has long had, a shortage of nursing staff, with a supply of 6.8 per thousand inhabitants in 2022. In 2023, there was also a worsening of the indicator on trust in healthcare personnel in the last 3 years: the 20.1% of citizens assigned a rating from 0 to 5 to doctors and 21.3% to other healthcare personnel; the percentages are highest in the South (24.2% and 26.6% respectively). Meanwhile, hospital emigration outside the region has returned to pre-Covid levels, equal to 8.3% of hospitalizations under ordinary acute care in 2022. Basilicata, Calabria, Campania and Puglia are the regions with the highest uncompensated outflows from incoming flows; in Sicily and Sardinia, although the hospital emigration index is low, it is much higher than the hospital immigration index.