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World Health Systems Facts

Italy: Health System Expenditures

Italy: Health System Expenditures

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Total Health Spending, USD PPP Per Capita (2020): $3,819

(Note: “Health spending measures the final consumption of health care goods and services (i.e. current health expenditure) including personal health care (curative care, rehabilitative care, long-term care, ancillary services and medical goods) and collective services (prevention and public health services as well as health administration), but excluding spending on investments. Health care is financed through a mix of financing arrangements including government spending and compulsory health insurance (“Government/compulsory”) as well as voluntary health insurance and private funds such as households’ out-of-pocket payments, NGOs and private corporations (“Voluntary”). This indicator is presented as a total and by type of financing (“Government/compulsory”, “Voluntary”, “Out-of-pocket”) and is measured as a share of GDP, as a share of total health spending and in USD per capita (using economy-wide PPPs).”

Source: OECD (2021), Health spending (indicator). doi: 10.1787/8643de7e-en (Accessed on June 10, 2022).


Current Health Expenditure Per Capita (USD) (2019): $2,906

Source: Global Health Observatory. Current health expenditure (CHE) per capita in US$. Geneva: World Health Organization. Last accessed June 10, 2022.


Current Health Expenditure As Percentage Of Gross Domestic Product (2019): 8.67%

Source: Global Health Observatory. Current health expenditure (CHE) as percentage of gross domestic product (GDP) (%). Geneva: World Health Organization. Last accessed June 10, 2022.


Out-Of-Pocket Expenditure As Percentage Of Current Health Expenditure (2019): 23.31%

Source: Global Health Observatory. Out-of-pocket expenditure as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed June 10, 2022.


Out-Of-Pocket Expenditure Per Capita (USD) (2019): $677.4

Source: Global Health Observatory. Out-of-pocket expenditure (OOP) per capita in US$. Geneva: World Health Organization. Last accessed June 10, 2022.


Domestic General Government Health Expenditure as Percentage of General Government Expenditure (2019): 13.2%

Source: World health statistics 2021: monitoring health for the SDGs, sustainable development goals. Geneva: World Health Organization; 2021. Licence: CC BY-NC-SA 3.0 IGO.


“In 2019, Italy spent 8.7 % of GDP on health care, compared to the EU average of 9.9 %. In the same year, per capita spending reached EUR 2,525 (adjusted for differences in purchasing power), which is over 25 % below the EU average (EUR 3,523) (Figure 7). Historically, health expenditure in Italy has always been lower than the EU average, but slow increases have occurred over the last five years, mainly driven by a growth in private spending. Public spending as a proportion of total health expenditure was 74 % in 2019 – lower than the EU average of 80 %. Most of the remaining expenses came from direct out-ofpocket (OOP) payments by households (23 %), as voluntary health insurance (VHI) only plays a minor role (covering only 3 % of the total). The COVID-19 emergency prompted additional funding injections in 2020 to support the health sector (Box 3).”

Source: OECD/European Observatory on Health Systems and Policies (2021), Italy: Country Health Profile 2021, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.


“Public sources made up 78.2% of total health-care spending, with private spending, mainly in the form of OOP payments (17.8%), accounting for the remainder – these OOP payments are mainly for diagnostic procedures (laboratory tests and imaging), pharmaceuticals, specialist visits and for unjustified (non-urgent) interventions provided in hospital emergency departments. Only about 1% of total health-care expenditure is funded by private health insurance. The production, distribution and pricing of pharmaceuticals are strictly regulated by a national agency, and provisions are made progressively more complex by repeated attempts at cost containment of pharmaceutical expenditure.”

Source: Ferré F, de Belvis AG, Valerio L, Longhi S, Lazzari A, Fattore G, Ricciardi W, Maresso A. Italy: Health System Review. Health Systems in Transition, 2014, 16(4):1–168.


“In Italy, as in most OECD countries, health expenditure has steadily increased over time, making its containment a major issue for governments. However, it is noteworthy that public health-care expenditure remained virtually unchanged between 2010 and 2012 (with a +1.1% average yearly change). The recent history of health-care expenditure is marked by attempts to place stricter control over regions’ health spending after a few regions incurred considerable deficits. To address this financial failure, the government introduced a special regime for overspending regions that requires the adoption and implementation of formal regional ‘financial recovery plans’ (Piani di Rientro). Since 2007, ten4 out of the twenty-one regional health systems have adopted these plans, which include actions to address the structural determinants of costs. All subsequent dynamics of public spending for health care must be seen in light of these provisions. The overall effect of this regime has been a decrease in the yearly level of overspending. In 2012, the total deficit of the public health-care sector was €1.04 billion, declining by 77% since 2006 (€4.48 billion) (Armeni & Ferré, 2013).

“Total health expenditure (public and private) exceeded €140 billion in 2012 (9.2% of GDP) (Table 3.1), growing at a yearly average5 of 4.7% from 2000 to 2009 and by only 0.9% from 2009 to 2012. Since 2000, total health-care expenditure has increased by 1.3 percentage points of GDP (from 7.7% in 2000 to 9% in 2010), mainly because the public component has experienced rates of increase that are substantially higher than GDP. Only in the last three years (2010–2012) has the increase in public health-care expenditure been radically contained; thus, the ratio of total health-care expenditure to GDP has been stabilized.”

Source: Ferré F, de Belvis AG, Valerio L, Longhi S, Lazzari A, Fattore G, Ricciardi W, Maresso A. Italy: Health System Review. Health Systems in Transition, 2014, 16(4):1–168.


Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems in the US and several other nations.


Page last updated June 10, 2022 by Doug McVay, Editor.

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