The role of socio-economic determinants in the interregional allocation of healthcare resources: Some insights from the 2023 reform in the Italian NHS

Roberto Fantozzi, Stefania Gabriele and Alberto Zanardi

Health Policy, 2025, vol. 152, issue C

Abstract: This paper discusses a reform recently implemented in the Italian National Health Service, aimed at adding some socio-economic indicators to the criteria adopted for allocating healthcare funding to Regions. The reform is based on international experience in healthcare financing in decentralized settings and provides a case study of special interest since Italy is a country with significant territorial disparities and severe budget constraints. The paper first discusses the long-standing debate between Italian Regions which led to the reform. Second, it reviews the main features of the reform which provides for the inclusion of socio-economic indicators via a simplified formula. Moreover, a possible revision of the reform is proposed, fully exploiting the information on the heterogeneity of health needs according to age and socio-economic indicators. By integrating the information on deprivation inside the risk adjustment mechanism, the weight of the different drivers is determined by the distribution of needs and not on a discretionary basis. Simulating the proposed revision suggests that more resources could be allocated to the Regions with higher levels of deprivation compared to a scenario that closely replicates the reform.

Keywords: Healthcare; Resource allocation; National Health Service; Italy (search for similar items in EconPapers)
JEL-codes: H51 H75 I18 (search for similar items in EconPapers)
Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:152:y:2025:i:c:s0168851024002501

DOI: 10.1016/j.healthpol.2024.105240

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