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VOLUME 49 | NUMBER 3 | JUNE 2014


Equity in Access to Health Care Services in Italy

Keywords: Health care utilization; horizontal equity; SES inequity; Italy.

Objective: To provide new evidence on whether and how patterns of health care utilization deviate from horizontal equity in a country with a universal and egalitarian public health care system: Italy.

Data Sources: Secondary analysis of data from the Health Conditions and Health Care Utilization Survey 2005, conducted by the Italian National Institute of Statistics on a probability sample of the noninstitutionalized Italian population.

Study Design: Using multilevel logistic regression, we investigated how the probability of utilizing five health care services varies among individuals with equal health status but different SES.

Data Collection/Extraction: Respondents aged 18 or older at the interview time (n = 103,651).

Principal Findings: Overall, we found that use of primary care is inequitable in favor of the less well-off, hospitalization is equitable, and use of outpatient specialist care, basic medical tests, and diagnostic services is inequitable in favor of the well-off. Stratifying the analysis by health status, however, we found that the degree of inequity varies according to health status.

Conclusions: Despite its universal and egalitarian public health care system, Italy exhibits a significant degree of SES-related horizontal inequity in health services utilization.

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