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Country’s healthcare system in a nutshell
Italy operates a Italy’s regionalised National Health Service (Servizio Sanitario Nazionale, SSN) , which has provided universal coverage to all citizens and legal residents since 1978. The SSN is organised under the national Ministry of Health and administered on a regional basis. The central government oversees the system, Central government establishes the national benefits package , and allocates funding to the regions, which . The regions are responsible for financing, planning, and delivering healthcare services at the local level.
The SSN is primarily funded through a combination of regional and national taxes, with pooled funds managed at the national level. Each region’s share of funding is determined by a formula that takes into account epidemiological factors such as population age structure and other epidemiological considerations. This formula is agreed annually between the national government and the regions at the State-Regions Conference, an intergovernmental forum for decision-making. The national government provides additional financial support through an equalisation fund, sourced from national value-added tax, to cover the gap between each region's estimated financial needs and their own revenue.
Out-of-pocket payments (OOP) payments in Italy are significantly higher than the EU EU’s average. For instance, in In 2019, Italy’s OOP in Italy accounted for 23.3% of total health expenditure , compared to while the EU average of was 15.4%. While some services, such as medications, outpatient specialist visits, and diagnostic tests, require co-payments, the The majority of OOP spending in Italy goes towards direct payments for services , not covered by the SSN particularly outpatient medical care and over-the-counter medications not covered by the SSN . Remaining OOP are co-payments for covered services such as medications, outpatient specialist visits, and diagnostic tests (World Health Organization, 2022).
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Public vs private
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The national PHR
History
From a normative perspectiveFascicolo Sanitario Elettronico (FSE), the Italian National PHR, known as the ‘Fascicolo Sanitario Elettronico (FSE)’ has been was introduced from Art. 12 of Law Decree 18 Oct 2012 n. 179 ( “decreto crescita”, converted into law 17 Dec 2012, n. 221). This . The law established that:
Each region had to create and implement a PHR by June 20, 2015.
The user interfaces, systems, and software must ensure full interoperability at regional, national, and European levels.
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(AGID Agenzia per l’Italia Digitale, 2023-2024)
Screenshots
Note: the screenshots refer to the FSE of the Emilia Romagna region, which, at the moment, is the one showing the highest utilisation.
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Lepida’s platform for Emilia-Romagna in Italy
Bibliography
AGID Agenzia Per l’Italia Digitale, n.d. Fascicolo Sanitario Elettronico - Monitoring. Available at: https://www.fascicolosanitario.gov.it/en/monitoring (accessed: 29 April 2024).
Ciampi, M., Esposito, A. and Sicuranza, M., n.d. Stato dell’arte sulle iniziative nazionali relative allo sviluppo di sistemi ICT interoperabili per la Salute Digitale. Available at: https://www.researchgate.net/profile/Mario-Ciampi/publication/334204495_Stato_dell'arte_sulle_iniziative_nazionali_relative_allo_sviluppo_di_sistemi_ICT_interoperabili_per_la_Salute_Digitale/links/5d1cc763299bf1547c94fbd3/Stato-dellarte-sulle-iniziative-nazionali-relative-allo-sviluppo-di-sistemi-ICT-interoperabili-per-la-Salute-Digitale.pdf (accessed: 29 April 2024).
CISL, 2023. Consumatori. Adiconsum Cisl: “The Current Electronic Health Record Without Interoperability Does Not Protect Citizens' Health and Increases Healthcare Costs, Making the Tool Useless and Ineffective”. (online) 26 January. Available at: https://www.cisl.it/notizie/categorie-ed-enti-cisl/consumatori-adiconsum-cisl-lattuale-fascicolo-sanitario-elettronico-senza-interoperabilita-non-tutela-la-salute-dei-cittadini-consumatori-e-fa-lievitare-i-costi-della-sanita-rende/ (accessed: 29 April 2024).
Gazzetta Ufficiale della Repubblica Italiana, 2022, 11 July. FSE (Allegato A). Gazzetta Ufficiale della Repubblica Italiana, Serie generale - n. 160, 11-07-2022. Available at: https://www.gazzettaufficiale.it/eli/id/2022/07/11/22A03961/sg .(accessed: 29 April 2024).
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