Web-economic-crisis-health-systems-and-health-web

Country profiles of health system responses to the crisis | Italy
417
• Reduction of NHS spending on public services contracts by 10%
compared with 2012 (2013).
• Mandated public hospitals to make purchasing requests through the National
Purchasing Agency for Medical Goods and Services (2012).
• Expenditure on medical devices reduced leading to reductions in Ministry
of Health spending:
àà
reduction of €22 million in 2013 (Health Ministry's budget planned
for 2013 was €278 million);
àà
reduction of €30 million in 2014;
àà
reduction of €35 million projected for 2015.
Overhead costs: restructuring the Ministry of Health and purchasing agencies
• No response reported.
Provider infrastructure and capital investment
• The government imposed a reduction in the number of hospital beds: 3.7
beds per 1000 population (down from 4 beds per 1000), of which 0.7 are
for rehabilitation and long-term care (2012). It also imposed a reduction
of the hospitalization rate from 180 per 1000 inhabitants to 160, 25% of
which should be in day hospitals (2012). All targets were to be achieved
by 30 November 2012.
Priority setting or protocols to change access to treatments, coordination
of care and patterns of use
• The government sought to improve coordination of care by requesting
the development of GP group practices, integration between hospital and
primary care services and adoption of policies aimed at shifting patients
from inpatient hospital care to day-hospital care or to community/home
care (2012).
Waiting times
• Introduction of a range of policies to improve timely access to services, including
the introduction of priority groups and specific diagnostic–therapeutic
pathways with the involvement of GPs, volume controls for outpatient care by
priority group, increased capacity through agreements with NHS providers,
identifying facilities with guaranteed maximum waiting times, direct
purchasing of extra visits and tests from private providers by local health
units, activating central booking centres, penalties for patients who do not
keep appointments and making user charges payable prior to accessing care
(introduced with the National Health Plan (Piano Sanitario Nazionale)