In Italy, due to the particular form of healthcare service growing nowadays, researches like these are really significant. Because of a sequence of reforms that had taken place during the 2000s in the Sate Healthcare System (the Servizio Sanitario Nazionale), the regional level has now much more accountabilities than before. This actually has leaded to the existence of a plurality of different regional based services . In addiction, by means of setting basic assistance levels and the model of their allocation, practices of offer rationalization could now concur in generating new social inequalities. With this article, the authors try to understand how social assistance services affects health inequalities on a regional basis.
Regional welfare indicators : demand, supply and performances
Regional differences in healthcare services have been analysed looking at three fundamental aspects : demand, supply and performances. The first can be divided in two facets : the demographic one (which correspond to mortality rates and percentage of individuals older than 65) and health needs (medicine consumption, percentage of disabled people older than six years and of people with a chronic disease). The health supply can also be seen as composed of two part : one referred to service structures (number of doctors and beds in hospital and residential structures, health expenditure per capita and presence of CAT equipment), and one to extra health-services (non-hospital medical and clinical laboratories). The last indicator deals with healthcare service performance and refers on two aspects : functionality (computed by percentage of : hospitalisations, voluntary discharge from hospital, caesarian births and integrated home care) and attractiveness (considered by means of measuring the grade of satisfaction for health are services). The following table one points out that Italian Sate Healthcare System is characterized by a high heterogeneity.
Differences among regions by means of welfare indicators
|Health Needs||Service Structures||Extra health services||Functionality||Attrac-|
|Friuli Venezia Giulia||++||-||++||++|
So, while centre regions shows a high demand of health services, the northern ones highlights health needs below the average. Also Southern regions points out a quite different profile from the regions of the North. Beside the low demand in terms of demographic aspects, the firsts have a need for service structures, which is complementary to the low satisfaction for the performances of the existing healthcare system. To summarize, the regions that illustrate the better situation are the northern.
Does regional disparities affect social inequalities ?
Exploiting ISTAT  data on the perceived and physical health status of individuals, the authors try to give an answer to this relevant ad interesting question. Relying on multivel models they estimated how much of the variance in health status can be attributed to individual component and how much to contextual conditions. The analysis carried out emphasize not only the prevailing role of personal characteristics like sex, age and personal qualification on the contextual features, but also the extreme difficulty in finding social-institutional factors on a regional basis capable of deal with the low regional variance. In conclusion, despite the presence fo local inequalities, they do not seem to influence the perceived and physical health status of individuals.