Chapter 2

Figure 3 – Health expenditure as a percentage of GDP, 2003
12,00
11,00
10,00
9,00
8,00
7,00
6,00
5,00
4,00
7,40
Piemonte
6,96
Valle d’Aosta
6,47
Lombardia
Source: Our processing of ISTAT data
7,14 7,19
Trentino A.A.
Veneto
7,62
Friuli V.G.
7,82
Liguria
7,09
Emilia Romagna
1.2.2 The model used
In the attempt to explain the trend of total health expenditure and forecast it for the future,
economic, demographic and institutional variables have been integrated.
GDP constitutes a proxy for the economic level reached. Theory, and also previous empirical
evidence, suggest that, at aggregate level, there is a positive correlation between
economic condition and the quota assigned to health expenditure.
As demographic variables, the percentage of the population aged over 65 and the generic
mortality rate were used, the aim being to take account both of the phenomenon of
aging of the Italian population and to verify the applicability to Italy of the theory of the
so-called costs of death.
At the institutional level, the decision on the proportion of the need to cover by public
sector action seems to summarize the changes under way in the Italian system. As
already noted, in the last decade the Italian (1990-2003) private health expenditure, as a
percentage of GDP, has risen faster than that of public health expenditure 3 .
Furthermore, there are marked differences among the Regions in mechanisms as to provision
of the public services, in particular in the extent to which services are operated
directly or contracted out, it seemed interesting to investigate the effect of these differences
on total expenditure. Finally, considering the considerable evidence that exists on
3 Quaderno Cerm 2/06 Spesa Sanitaria, Demografia, Governance Istituzionale; F. Pammolli e N. C. Salerno.
7,43
Toscana
8,37
Umbria
7,87
Marche
7,97 7,97
Lazio
Abruzzo
[59]
9,34
11,31
10,96
Molise
Campania
10,38
Puglia
9,86
Basilicata
11,22
Calabria
10,28 9,86
Sicilia
Sardegna
CEIS Health Report 2006