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The number of Italians who are giving up treatment is growing to 4.5 million, both for economic reasons but above all as a result of the waiting lists which have exploded since the pandemic and make it increasingly difficult to access visits and tests in the Health Service. What pushed the numbers up of this army that chooses not to take care of their health – last year there were just over 4 million – were precisely the excessively long waits to which patients are forced: in 2019 before Covid there were few more than 1.5 million Italians who, faced with too long lists, gave up on treatment, have become almost 3 million in 2023. Compared to last year, however, the share of those who give up for economic reasons also increases. The merciless numbers that confirm the alarm about the conditions of Italian healthcare come from Istat’s Report on Fair and Sustainable Wellbeing (Bes). Waiting lists make them enemy number one and it is no coincidence that the Government is working on a plan to be presented in the next few days.
The number of Italians who give up treatment is growing
Istat captures the situation well by lining up the numbers of this alarming situation: «The share of people who have had to do without care amounts to 7.6% of the entire population in 2023, an increase compared to to 7.0% of the previous year. With 372 thousand more people we reach – explains the BES Report – a contingent of around 4.5 million citizens who have had to give up visits or checks due to economic problems, waiting lists or access difficulties”. «This increase – continues Istat – can be attributed to direct and indirect consequences of the pandemic shock, such as the recovery of pending benefits deferred due to COVID-19 or the difficulty of effectively reorganizing healthcare, taking into account the constraints on cover the increase in demand for services with an adequate number of professional resources and, last but not least, the inflationary push of the economic situation, which has worsened the ability to access health services”. In short, the phenomenon of giving up treatment, due to economic problems and long waiting lists, remains dramatic and, more seriously, is also worsening. As mentioned, in particular, there is a doubling of the share of those who renounced due to waiting list problems (from 2.8% in 2019 to 4.5% in 2023) while the renouncement for economic reasons remains stable (from 4.3 % in 2019 to 4.2% in 2023), but still increasing compared to 2022 (+1.3 percentage points in just one year).
The elderly are the most defeatist, Sude and Centro the most affected
Among other things, another worrying element is the fact that the percentage of people giving up healthcare services increases with age and therefore precisely when there is the greatest need to access healthcare services. In 2023, starting from the 1.3% recorded among children up to 13 years of age, the share shows a peak in adulthood among 55-59 year olds, where it reaches 11.1%, to remain high among the elderly aged 75 and over (9.8%): in practice one in 10 over 55s gives up treatment. The well-known gender differences are then confirmed: the rate of renunciation is equal to 9.0% among women and 6.2% among men, «with a gap that widens further in the last year due to the increase recorded among adult women”, reports Istat. On the territory, the increase in 2023 compared to the previous year is concentrated above all in the Center and the South: in the former there is the highest percentage of renunciations (8.8%), followed by the South with 7.7%, while the North with 7.1% maintains the same level as 2022. However, there are few regions that in 2023 return to lower levels than 2019. In particular Sardinia, with the highest renouncement rates already in 2019 (11.7% ), continues to increase them (13.7% in 2023). Among the regions of the Centre, apart from Tuscany which returns to the 2019 value, Lazio reaches 10.5% (it was 6.9% in 2022 and 7.6% in 2019) and the Marche 9.7% ( it was approximately 7% in both 2022 and 2019). In the North, the highest rate of renunciation is recorded in Piedmont with 8.8%, followed by Liguria, with 7.8% (both regions increase by 3 points compared to 2019).
The Government is preparing an intervention in the next few days
«In this investigation – highlights Filippo Anelli, president of the National Federation of Medical Associations (Fnomceo) – the main responsibility is given to the waiting lists. The reflection is that, if we want to maintain this National Health Service, which is increasingly at risk today, we need to act, taking into account that we are faced with an organizational problem aggravated by the lack of personnel. Today, therefore, an extraordinary intervention involving operators is essential. Some issues can be resolved, without resorting to foreign doctors, with: the use of the 50 thousand specialist doctors, who have degrees and can practice; we then have the possibility of extending the freelance profession, eliminating a series of constraints, to white coats who work in the NHS and allowing them to make themselves available to healthcare companies, in very precise terms, to provide answers to waiting lists without them paying the citizens”. However, the Government is ready for a new intervention on the waiting lists. A possible law decree is already expected at the end of the month with an endowment of 500-600 million to be allocated precisely to reducing waiting times for treatment. The measures also include greater control of inappropriate prescriptions made by doctors who contribute to swamping the NHS, in addition to funds for extra staff work and for the use of accredited private facilities.