An analysis of the regional differences in health care utilization in Italy.

This paper focuses on the differences in regional expenditure on health care in the attempt to verify how equitable is the pattern of health care supply across the Italian regions and whether disparities are related to the existing socioeconomic imbalances, especially in terms of the North-South divide. The analysis has been carried out according to an egalitarian view of equity. For several categories of health services simple concentration measures and an horizontal inequity index have been derived to quantify the degree of inequity due to the discrepancy between the actual regional expenditure and a "just" amount implied by need indicators. Findings are that richer areas spend more than the "fair" amount on hospital and residential care as well as on the overall health care system, whereas inequity favouring poorer areas occurs in the delivery of pharmacological and secondary care. Copyright 2009 Elsevier Ltd. All rights reserved.