While the central government provides guidelines, setting the fundamental principles and standards of the healthcare system, the regions are responsible for allocating and managing the resources, as well as for providing and promoting health care services. The fact that the system is, to some extent, decentralized, however, leads to great disparities in the quality and the accessibility of health services across regions. Despite this, Italians are overall quite satisfied with the services they receive, and have a high level of trust in the system as a whole, and in particular in family doctors.
Family doctors, or General Practitioners (GP), represent the first link between patients and the national health system (for individuals under the age of 16 this link is represented by pediatricians). A GP’s role is to provide primary care, which involves evaluating and monitoring patients’ health status, writing prescriptions, as well as requesting access to examinations, consultations with specialists, hospitalizations and treatments. The high level of trust in GPs, who are paramount for the system’s functioning, is also proven by the fact that 44 percent of Italians visit their GP three or more times a year.
When it comes to managing hospitals, public funds are allocated by regional health units to public and accredited private hospitals. The majority of hospitals in Italy are public and are either managed directly by local health units or operate as semi-independent public enterprises. In recent years, the number of hospitals has decreased, which, as a consequence, led to a decrease in the number of beds.
Despite regional disparities, structural issues and cuts in funding, the system has proved to be resilient and Italy is listed among the countries with one of the best healthcare systems worldwide, according to the World Health Organization. The outbreak of the coronavirus (COVID-19) pandemic, however, has put the system under considerable pressure.