The population of Italy in 1995 was 57,332,996 with a total of 526,064 newborns. The population is highly heterogeneous as a result of many migrations through the centuries. The high frequency of thalassaemia and haemoglobinopathy heterozygotes is particularly noteworthy in the populations originating from South Italy, Sardinia, Sicily, Po River delta, and the Ferrara country.

Health care expenditure is about 5% of GNP. The ‘challenges’ to health services result from their current bureaucratic and weak structure and historical precedents. Based on the most recent reform law of the National Health System (SSN, 1992), the situation is characterised by great autonomy, both organisational and financial, at the level of the 20 regions to which the National Ministry of Health assigns budgets based on population numbers. In addition, the Ministry publishes basic guidelines, standardises the level of assistance, defines regional responsibilities, promotes partnerships with universities, defines standard fees for hospitals and agreed private bodies, and defines the personnel employment criteria in the public and certified private bodies. At the regional level, health care is organised by the Aziende Sanitarie Locali including hospitals and territory services (in Italian: poliambulatori). A number of large and highly specialised hospitals are managed as ‘enterprises’ with strong economic and financial autonomy. Thirty-two hospitals which are classified as ‘Istituti di Ricovero e Cura a Carattere Scientifico’ receive special funds for research from the Ministry of Health. The budgets are allocated at a regional level, according to the specific local services and the volume of activities.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account
Continue with Google
Continue with ORCiD