Chapter 2

CEIS Health Report 2006
Table 1 – Regional Health Funds in 2005 (Euro)
REGIONS REGIONAL HEALTH FUNDS
Piemonte 6.622.600.757
Toscana 5.594.453.637
Lazio 7.764.490.374
Campania 7.962.288.536
Calabria 2.917.739.679
Sicilia 7.217.363.396
Sardegna 2.357.013.787
Source: Ministry of Health, 2006
the hospital and territorial services.
There is a high regional variability:
• for the year 2005, resources assigned to hospital services varied from 41% for
Campania and Sardegna to 48,0% for Sicilia;
• resources assigned to territorial services are even more variable with 28,6% for
Campania to 52% for Toscana 5 . This may be explained by the process of regional assignments
to the item defined as “Other” (i.e. for Campania), which is made up of Mental
Health resources, Regional Agency for the Environment, etc.
Four Regions (Campania, Lazio, Sicilia and Sardegna) assigned some resources to specific
destinations, for example centred functions to Hospital and Health Units: 5,5% of
Regional Health Funds to Sardegna, 7,8% to Lazio and 2,9% to Sicilia.
These different situations represent the regional autonomy. The difference in the shares
to health services should be due to the federalist point-of-view, to the achievement of
increased internal efficiency, that should be turned into an allocation more in keeping with
the regional specificities of available resources (for example structure by population age).
However there is a risk that the shares are instead determined ex-post on the historical
expenditure and therefore on choices (or non- choices) made in the course of time regarding
health planning and in particular supply re-qualification.
For example, regarding hospital services, a loan bound to existing patient capacity and
fit for covering costs of hospital structures that does not take into consideration the real
health service demand, could determine a situation of inefficiency rather than configure
an incentive to achieve the rationalization of the supply system. The analysis of regional
decisions in this area seems to demonstrate that greater hospital accommodation is
effectively associated with greater funding of hospital services. The Lazio Region, for
example, assigns the highest quota to hospital services (52,5%, divided into 44,7% for
“free destination” and 7,8% allocated to specifics healthcare structures) and at the same
time has the largest amount of patient accommodation (5,2 beds every 1.000 citizens),
5 These results confirm regional variability for 2003 and 2004 reported in the CEIS Health Report 2005.
[158]