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Current Health Expenditure As Percentage Of Gross Domestic Product, 2020: 9.63%

Source: Global Health Observatory. Current health expenditure (CHE) as percentage of gross domestic product (GDP) (%). Geneva: World Health Organization. Last accessed May 14, 2023.

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Current Health Expenditure Per Capita in USD, 2020: $3,057

Source: Global Health Observatory. Current health expenditure (CHE) per capita in US$. Geneva: World Health Organization. Last accessed May 13, 2023.

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Out-Of-Pocket Expenditure As Percentage Of Current Health Expenditure, 2020: 21.28%

Source: Global Health Observatory. Out-of-pocket expenditure as percentage of current health expenditure (CHE) (%). Geneva: World Health Organization. Last accessed May 13, 2023.

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Out-Of-Pocket Expenditure Per Capita in USD, 2020: $650.5

Source: Global Health Observatory. Out-of-pocket expenditure (OOP) per capita in US$. Geneva: World Health Organization. Last accessed May 13, 2023.

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Annual household out-of-pocket payment in current USD per capita, 2021: $729

Source: Global Health Expenditure Database. Health expenditure series. Geneva: World Health Organization. Last accessed May 13, 2023.

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Total Health Spending, USD PPP Per Capita (2021): $4,043

(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 (2023), Health spending (indicator). doi: 10.1787/8643de7e-en (Accessed on 24 May 2023).

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Domestic General Government Health Expenditure as Percentage of General Government Expenditure (2020): 12.9%

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.

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“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.

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“According to national ISTAT data, current health expenditure in 2019 was equal to EUR 154.8 billion, of which EUR 114.8 billion was publicly funded and the remaining EUR 40 billion was incurred by families and other private entities (Del Vecchio et al., 2020; 2021). Preliminary estimates for 2020 showed a significant increase in public spending (EUR 122.4 billion) and a reduction in private expenditure (EUR 38.1 billion) (Del Vecchio et al., 2021). The COVID-19 pandemic required additional public expenditure to cope with the emergency, while private health care expenditure decreased due to the suspension of non-urgent services and patients’ reluctance to visit health care facilities.

“Based on data from the Global Health Expenditure Database in 2019, Italy’s health spending represented 8.7% of GDP (Table 3.1 and Fig.3.1).5 The share of GDP for health care grew steadily from 7.6% in 2000 to 8.9% in 2010, then declined slightly to 8.7% in 2019. Although this is a little above the EU average (8.5%), Italy remains the lowest spender when compared with countries such as Spain, France, the United Kingdom, and Germany (Fig.3.2). In 2019, per capita health expenditure stood at US$ 3 998 (adjusted for differences in purchasing power). While this is above the average across the WHO European Region it is somewhat below the average for EU/European Economic Area (EEA) countries and the United Kingdom (Fig.3.3).”

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“Over the last two decades, public expenditure on health has fluctuated. It grew by an average annual growth rate of 4.1% from 2000 to 2010, and by only 0.9% from 2011 to 2019. Instead, private expenditure has shown a more constant pattern (about 2.1% average annual increase). The government share of current health care expenditure decreased significantly from 78.5% in 2010 to 73.9% in 2019 (Table 3.1). Both public and private health expenditure suffered from the country’s modest GDP annual growth which averaged 2.4% between 2001 and 2010 and only 1.1% between 2011 and 2019. This left little room to increase the share of GDP dedicated to the SSN, given Italy’s very high public debt/GDP ratio. In addition, private expenditure on health did expand despite a weak economy that increased the disposable income of families only modestly.”

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“National data highlights that in 2019, per capita public expenditure by the regional health care systems ranged from EUR 1,845 in Campania and EUR 1,909 in Sicily (southern Italy) to EUR 2,476 in Molise (southern Italy) and EUR 2,457 in the Autonomous Province of Bolzano (northern Italy) (Table 3.2). Differences are mainly due to funding – northern regions tend to receive more resources due to an older population – and to regions being able to deliver services beyond those guaranteed under the national benefits package (LEA). It is worth noting that the financial flows due to the mobility of patients seeking care outside their region of residence also impacts on regional differences in per capita health spending. These flows tend to go from the southern to northern regions given that public and private-accredited hospitals in northern regions (mainly in Lombardy and Emilia-Romagna) attract patients from southern regions (mainly from Calabria and Campania) (Fattore, Petrarca & Torbica, 2014; Brenna & Spandonaro, 2015). The private share of per capita expenditure shows much greater variation across the country ranging, from a minimum of EUR 423 in Campania to a maximum of EUR 899 in the Valle d’Aosta. These data suggest that private expenditure is mainly related to families’ disposable income (higher in the northern regions) rather than to the performance of public regional health systems (Del Vecchio et al., 2020).”

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

Page last updated October 10, 2023 by Doug McVay, Editor.