Geographical variation in the use of private health insurance in a predominantly publicly-funded system

Marianna Cavazza; Mario Del Vecchio; Giovanni Fattore; Lorenzo Fenech

doi:10.1016/j.healthpol.2023.104720

Geographical variation in the use of private health insurance in a predominantly publicly-funded system

Health Policy. 2023 Apr:130:104720. doi: 10.1016/j.healthpol.2023.104720. Epub 2023 Feb 3.

Authors

Marianna Cavazza¹, Mario Del Vecchio², Giovanni Fattore³, Lorenzo Fenech⁴

Affiliations

¹ Centre for Research on Health and Social Care Management (Cergas), SDA Bocconi School of Management, Observatory on Privately Financed Health Consumption (OCPS), Via Sarfatti 10, Milan 20136, Italy. Electronic address: marianna.cavazza@unibocconi.it.
² Centre for Research on Health and Social Care Management (Cergas), SDA Bocconi School of Management, Observatory on Privately Financed Health Consumption (OCPS), Via Sarfatti 10, Milan 20136, Italy; Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3, Florence 50134, Italy.
³ Centre for Research on Health and Social Care Management (Cergas), SDA Bocconi School of Management, Observatory on Privately Financed Health Consumption (OCPS), Via Sarfatti 10, Milan 20136, Italy; Social and Political Sciences Department, Bocconi University, Via Roentgen 1, Milan 20136, Italy.
⁴ Centre for Research on Health and Social Care Management (Cergas), SDA Bocconi School of Management, Observatory on Privately Financed Health Consumption (OCPS), Via Sarfatti 10, Milan 20136, Italy.

PMID: 36801610
DOI: 10.1016/j.healthpol.2023.104720

Abstract

We provide evidence of geographical variations in the use of private health insurance (PHI) in Italy. Our study offers an original contribution, using a 2016 dataset on the use of PHI amongst a population of more than 200,000 employees of a major company. The average claim per enrolee was €925, representing approximately 50% of public health expenditure per capita, primarily for dental care (27.2%), specialist outpatient services (26.3%) and inpatient care (25.2%). Residents in northern regions and metropolitan areas respectively claimed reimbursements for €164 and €483 more than those in southern regions and in non-metropolitan areas. Both supply and demand factors can explain these large geographical differences. The study suggests the urgency for policymakers to address the considerable disparities in the Italian healthcare system, revealing the overall social, cultural and economic conditions that shape the demand for healthcare.

Keywords: Geographical inequalities; Italy; National health service; Private health insurance.

MeSH terms

Delivery of Health Care*
Geography
Health Expenditures
Humans
Insurance, Health*
Italy / epidemiology