How much do you turn to private healthcare for health needs? How many tests do we do privately? In times of waiting lists it is certainly easy to know the answer, but to give it weight and perspective a precise and accurate analysis was necessary. They thought about it there Mario Del Monte Foundation and the Gorrieri Foundationwho promoted the study.
I study
The constructed report attempts to provide information on the percentage weight of the revenues coming from the private activity of doctors on what a specific healthcare company produced during the analysis period considered. Taking into consideration the period 2015-2022, Emilia-Romagna is positioned slightly above the national average, with a weight of revenues from intramoenia of just under 1.5%. Furthermore, a significant difference emerges in terms of the weight of revenues from intramoenia between the regions of the North and those of the South, with the southern ones being characterized by a low incidence of revenues from intramoenia.
And in Modena?
«Replicating the analysis – specified the prof. Marcello Morciano – narrowing the focus only on Emilia-Romagna, it emerges that Modena and Bologna represent the two territories with the highest impact of intramoenia revenues on the total, with the rest of the territories grouped below. In particular, we note the growth that the Modena area has had post-Covid, clearly superior to other areas, which has led it to reach Bologna in first place in the Region. The analysis carried out on the number of visits in Emilia-Romagna (ReportER regional data) highlights a strong growth in the percentage of intra-moenia visits on the total visits provided in the Modena area since 2010. Even in the percentage of intra-moenia visits, the Modena area is ranks among the top in the Region, accompanied by Bologna. The post-2010 surge in Modena is due to a slight decline in the total number of visits combined with an almost doubled number of visits provided intramoenia”.
The analysis
«The analysis presented during the conference was carried out using three different sources: national data on the economic accounts of public healthcare facilities, ASA regional data on the provision of healthcare services in Emilia-Romagna and individual microdata provided by the Sassuolo Hospital – continues Morciano – the objective is to contribute to research on the state of health of public health, within which intramoenia (the free intramural profession also called “intramoenia” refers to services provided outside normal working hours by doctors of a hospital, who use the outpatient and diagnostic facilities of the hospital itself in exchange for the payment of a fee by the patient) represents a middle ground between the public service provided “freely” to citizens and regulated private hospitals by the laws of the market. In this sense, we tried to frame Emilia-Romagna in the national context, and then shift the focus to the regional context, comparing the Modena area with the other regional territories covered by a local health authority. Finally, we tried to observe the behavior of citizens of Emilia-Romagna in the use of intramoenia in order to highlight any trends to keep under observation with a view to protecting equal access to healthcare. The analysis of the economic accounts of Italian healthcare companies was carried out using the BDAP database provided by the State General Accounting Office while, to credibly compare territories of different sizes, a ratio was constructed between the revenues from intramoenia services on the production value”.
The project
«45 years have now passed since the National Health System was established in 1978 and I immediately say that our foundations are on the side of the idea that was at its basis – underlined the president of the Mario Del Monte Roberto Guerzoni Foundation, also representing the Gorrieri Foundation together with which this research was promoted – that is, a universal and public service for all citizens, financed by general taxation. The project is driven by the strong concern that, for some time, this original inspiration has been dismantled. In this belief we are in good company, also given the recent appeal by 14 eminent personalities from the scientific and cultural world, who expressed a true cry of alarm addressed to politics and society as a whole. If we add to this that the Court of Auditors recently wrote that “the national health service suffers from a systemic crisis and no longer guarantees the population effective equality of access to health services”, it is clear that this is where we need to start ».
What changes
«The concern – he continued – is based on indisputable elements, the first being the lack of resources. The data is known and confirmed by the recent Def approved by the government. In Italy we are at 6.4% of GDP for public health spending and in the next few years it will fall further to 6.2% in 2027: below the European average and far from countries like Germany and France. The second is the lack of staff in essential services and specializations, the third is the evident lengthening of waiting lists for visits and services, when this does not also translate into giving up treatment. This situation produces a shift towards private responses and solutions with evident discrimination with respect to people’s economic and social conditions. The increase in private healthcare spending is known, which was 30.48 billion in 2017 and reached 40.26 billion. A growth that is accompanied by an increase in investments and activities by private companies and in parallel with the expansion of the health insurance sector, partly favored by contractual solutions.”
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