Healthcare is not the same for everyone. It almost never was, but now things are worse. While the assistance system creaks due to economic and personnel problems and the government decides to further reduce the value of health expenditure compared to GDP, the Regions each travel on their own.
And so it happens that in Emilia-Romagna the public system does almost 10 abdominal ultrasounds for every 100 inhabitants in a year (2022) while in Calabria the figure drops to 3.1. It means that on the one hand patients undergo too many checks and thus risk inappropriateness, and on the other they are seen too little. Remaining on the same exam, the Italian average is 6, the ideal level in theory.
However, if we look at those who work less, we need to make a further distinction. In certain situations in the South there may actually be a lower public offer than in the Centre-North. Elsewhere, however, the data contained means something else: that people choose the private sector. That is, they pay to avoid waiting times and cumbersome booking systems. It happens, for example, in Lazio, where alongside the 3.5 abdominal ultrasounds done in the public there are certainly many other paid ones. The same could be said for Sicily (4.1).
The figures were collected by Agenas, the national health agency of the Regions which took into consideration 10 specialist services and saw, in fact, how many were done in the various local realities in relation to the inhabitants. Among other things, the work of public and affiliated structures also in 2022 was lower than in 2019, i.e. the year before Covid. Precisely abdominal ultrasounds were 10% less, the first neurological visits 13%, the ophthalmological ones even 24%, and here the private sector probably weighed heavily. Services at risk of inappropriateness have increased, such as musculoskeletal MRIs (of the knees, shoulders and so on), i.e. +4.6%, and CT scans of the head (+6.8%). Follow-up visits, which involve people who already have a diagnosis, have dropped by a worrying 15%. And all this happens even if in practically all the Regions the waiting lists are long. Despite the reduction in demand, therefore, the offer fails to be adequate.
As regards the trend of other services in the Regions, musculoskeletal MRIs, one of the tests considered by radiologists to be at the greatest risk of inappropriateness, were 1.3 per 100 inhabitants in Sicily and 3.5 in Emilia-Romagna, which confirms the where more performance is done. The possibility that many of these activities are not necessary is high, given that in reality, like Piedmont, Lombardy and Tuscany, it remains around 2.
The electrocardiogram is a test that is often performed not alone but within a cardiological visit. Be that as it may, even in this case there are huge differences. The Italian average is 6.7 exams per 100 inhabitants but in Emilia-Romagna 10 tests are passed and in Liguria and the Marches they remain below 2. There are slightly fewer differences in the first neurological visits. Compared to an average of 1.6, it ranges from 0.8 in Bolzano to 2.5 in the usual Emilia-Romagna, in this case almost paired by Basilicata and Liguria.