Italy: Long-Term Supports and Supports

Life expectancy at birth, 2021: 82.7 years
Share of the population aged 65 and over, 2021: 23.6%
Share of the population aged 65 and over, 2050: 34.9%
Share of the population aged 80 and over, 2021: 7.6%
Share of the population aged 80 and over, 2050: 14.2%
Adults aged 65 and over rating their own health as good or very good, 2021: 43%
Adults aged 65 and over rating their own health as poor or very poor, by income, 2021
– Lowest quintile: 24%
– Highest quintile: 14%
– Total: 20%
Limitations in daily activities in adults aged 65 and over, 2021
– Severe Limitations: 16%
– Some Limitations: 32%
Estimated prevalence of dementia per 1,000 population, 2021: 23.4
Estimated prevalence of dementia per 1,000 population, 2040: 29.2
Total long-term care spending as a share of GDP, 2021: 0.9%
Share of informal carers among the population aged 50 and over, 2019
– Daily carers: 8%
– Weekly carers: 3%
Share of long-term care workers who work part time or on fixed contracts, 2021
– Part-time: 29.6%
– Fixed-term contract: 18.5%
Average hourly wages of personal care workers, as a share of economy-wide average wage, 2018
– Residential (facility-based) care: 62
– Home-based care: 59
Long-term care beds in institutions and hospitals per 1,000 population aged 65 years and over, 2021
– Institutions: 21.3
– Hospitals: 0.5

Source: OECD (2023), Health at a Glance 2023: OECD Indicators, OECD Publishing, Paris, doi.org/10.1787/7a7afb35-en.

Population, Mid-Year 2019: 60,550,000
Projected Population Mid-Year 2030: 59,031,000
Percentage of Population Under Age 25 Years, Mid-Year 2019: 23%
Percentage of Population 65 Years Or Over, Mid-Year 2019: 23%

Source: United Nations, Department of Economic and Social Affairs, Population Division (2019). World Population Prospects 2019: Data Booklet (ST/ESA/SER.A/424).

Long-Term Care Recipients In Institutions Other Than Hospitals, Total All Ages 2019: 479,807
Long-Term Care Recipients At Home, Total All Ages, 2019: 1,047,223

Source: Organization for Economic Cooperation and Development. OECD.Stat. Last accessed June 18, 2022.

“In 2050, one in three Italians are expected to be over 65 years old. Socioeconomic developments (e.g. decrease in multi-generational family units and an increase in female participation in the labour market) have contributed to reducing the availability of family caregivers to provide care and assistance to the elderly. Therefore, residential health facilities or retirement homes (Residenze Sanitarie Assistenziali, RSA) have been subject to a rapid, demand-driven expansion in the last two decades. Currently, there are 18.6 available RSA beds for every 1 000 older residents in Italy, well below the OECD average of 43.8, and these are mainly in central and northern Italy. It is difficult, however, to provide precise estimates since Italian regions use different denominations and organizational models, encompassing retirement homes, geriatric rehabilitation institutes, etc. Overall, RSAs are open-ended or temporary residence facilities. The Ministry of Health has indicated that they should be integrated within the existing urban fabric, in areas well connected by public transport, to avoid isolation. Their capacity can vary from 20 to 120 places, divided into modules of 20 residents each. One quarter of the available modules should be reserved for residents with dementia. Some RSAs have an “Alzheimer’s Nucleus”, an area dedicated to patients with cognitive and behavioural disorders.

“RSAs are mainly private. Local health authorities or social services regulate access to public or accredited RSAs upon GP’s or hospital doctor’s request, organize visits to the geriatric evaluation unit, and manage waiting lists. Only health service costs are borne by the SSN and vary according to the level of assistance provided. The remaining costs are borne by patients, municipalities and, indirectly, by the National Institute for Social Security (Istituto nazionale della previdenza sociale, INPS). Italy does not offer insurance136 Health Systems in Transitionfor long-term care; however, a universal national allowance (Indennità di accompagnamento; EUR 525 per month in 2022) is granted by Law 18/1980, irrespective of income status, to non-self-sufficient individuals. Large regional variations exist with regard to the additional resources topped up by other government entities (regions, municipalities).”

Source: de Belvis AG, Meregaglia M, Morsella A, Adduci A, Perilli A, Cascini F, Solipaca A, Fattore G, Ricciardi W, Maresso A, Scarpetti G. Italy: Health system review. Health Systems in Transition, 2022; 24(4): pp.i–203.

“Long-term care for elderly, cognitively or physically disabled people also can be provided in semi-residential settings, such as day centres. These centres provide social, health, rehabilitation, and educational services to people usually aged 18–65 years (although younger people can also be admitted) on the basis of individual projects (Ministero della Salute, undated). Similarly, integrated day centres (Centri Diurni Integrati, CDI) offer social and health care and services to people over 60.

“Lastly, the SSN guarantees home care, i.e. assistance in one’s own home, to non-self-sufficient people or those in a frail condition. Home care services are included in the national benefits package and thus are entirely paid by the SSN, upon a preliminary multidisciplinary evaluation of the patient’s health and social condition. Home care is divided into “scheduled home care” (Assistenza Domiciliare, AD) that provides medical, nursing and/or rehabilitation health services limited to the episode of illness in progress, and “integrated home care” (Assistenza Domiciliare Integrata, ADI) that consists of an integrated set of health and social treatments, delivered in a coordinated and continuous manner. Moreover, “home hospitalization” is a service characterized by diagnostic, therapeutic and rehabilitative services of high complexity and defined duration, provided by a specialist team usually recruited from hospitals.”

“In 2022, Italy’s life expectancy at birth was the third highest in the EU at 83.0 years, exceeding the EU average by 2.3 years (Figure 1). Throughout the decade preceding the COVID-19 pandemic, Italy’s life expectancy increased at a rate comparable to the EU average, despite already holding the second-highest life expectancy in the EU in 2010. However, in 2020 Italy experienced a large, above-average drop in life expectancy of 1.3 years, resulting from the large number of COVID-19 deaths in the first year of the pandemic. Over the subsequent two years, Italy’s life expectancy rebounded by 0.7 years, surpassing the EU average increase of 0.3 years. Despite this above-average rebound, in 2022 the life expectancy of the Italian population was still over 6 months below its pre-pandemic level.

“As in other European countries, men in Italy tend to have shorter lifespans than women. In 2022, the average life expectancy of women was85 years – over four years longer than that of men (80.9 years). This gender gap in life expectancy was nevertheless narrower than the EU average, which stood at nearly five and a half years.”

Source: OECD/European Observatory on Health Systems and Policies (2023), Italy: Country Health Profile 2023, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels.

Italy: Long-Term Services and Supports - Healthcare - informal carers, long-term care workers, home care, institutions, hospitals, staffing, expenditures - National Policies - World Health Systems Facts

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Page last updated April 21, 2025 by Doug McVay, Editor.