42% of Italians give up treatment due to economic problems

In 2023, 42% of patients with lower incomes, up to 15 thousand euros, were forced to procrastinate or give up healthcare because they were unable to access the National Health Service and were unable to bear the costs of paid healthcare. This is highlighted by the 21st ‘Hospitals & Health’ Report, promoted by Aiop (Italian Association of Private Hospitals) and created in collaboration with Censis.

The share of those who are forced to procrastinate or give up treatment drops to 32.6% of incomes between 15 thousand and 30 thousand euros, 22.2% of those between 30 thousand and 50 thousand euros and 14.7% of those over 50 thousand euros.

There are those who give up other expenses

The investigation also puts the spotlight on another alarming phenomenon: the “erosive effect” on wealth which, obviously, impacts differently on income classes. 36.9% of Italians have in fact given up other expenses to support healthcare: 50.4% among low incomes, 40.5% among medium-low incomes, 27.7% among medium-high incomes and 22.6% among tall ones.

Endless waiting lists

The share of citizens who, after having unsuccessfully attempted to access the NHS, turn to paid healthcare is 34.4% of the lowest incomes, 40.2% of the medium-low, 43.7% of the medium -tall and 41.7% of the tallest. “Waiting times that are inconsistent with the severity and complexity of the diagnostic question or diagnosis – we read in the survey – represent one of the elements of greatest unfairness within a system
universalistic, since they determine a gap between those who can turn to the market for healthcare services outside the NHS and those who, for economic-social reasons, cannot resort to paid healthcare. For the latter, the alternative is between waiting which could compromise, in whole or in part, their state of health and giving up treatment.”

Furthermore, the share of people who turn directly to paid healthcare is also increasing, given the awareness of the obstacles to accessing public healthcare: it is 40.6% of low incomes, 48.7% of medium-incomes. low, 57% of medium-high incomes and 63.3% of the highest incomes.

Healthcare mobility for 16% patients

Furthermore, in the last 12 months, 16.3% of people who needed to turn to health services went to another region, as part of the services provided by the Health Service, therefore net of any travel to access services under a private regime. The most recurrent reason for mobility, which concerns 31.6% of healthcare migrants (and 51.8% of those who declare they are in poor health), is that relating to the excessive length of waiting lists in their region.

To the patients who ‘migrate’ to other Regions we must also add 19.3% of those who – while remaining within the relevant regional health service – are forced to travel more than 50 km to benefit from the service they need. Among the reasons behind regional mobility in the Health Service, 26.5% of reports indicate the desire to obtain a better service, compared to what they believe would be obtained in their own regional Health Service.

Healthcare migrants

Added to this is 17.1% of healthcare migrants who did not find the particular type of healthcare service they needed. And again: 8.7% travel to get a second opinion, while 9.8% do so because they live in a border area and the facilities outside the Region are closer or more convenient. The Report highlights that 53.5% of Italians declare that, during the year, they had to face waiting times that were excessively long compared to the useful times; 37.4% report the presence of blocked or closed lists, despite them being formally prohibited. The result is that for every 100 booking attempts in the NHS, the services that remain in the public healthcare system (public and private accredited) are 60.6%.

The share that renounces and turns to paid healthcare – understood as pure private and intramoenia – is 34.9% (29.9% in the North-West, 26.5% in the North-East, 39.3% % in the Center and 40.7% in the South and Islands) and is broken down as follows: 11.9% intramoenia; 17.9% in the pure private sector; 5.1% in the private social sector; 4.6% in insurance policies.