1Health system performance and equity in Italy: a disease based approach

This draft is not for citation or quotation without the permission of the authors. Equitable access to health care is a core objective of the Italian health care systems. Despite having achieved close to universal coverage for a fairly comprehensive set of health services for decades, there is mounting evidence that not all individuals in equal need are treated equally, with inequalities systematically associated with income. The aim of the paper is to estimate income-related horizontal inequity in the access to health care (GP and specialist visits and hospital admission) standardising for people needs and the presence of chronic diseases. The measure of inequity is based on the indirect standardization approach proposed by Wagstaff and Van Doorslaer (2000). The data are taken from the Multiscopo survey, 1999-2000. The survey does not report income information, which was imputed by using the Eurostat survey (1999) for Italy (n=139,300). The measure of inequity is based on the indirect standardization approach proposed by Wagstaff and Van Doorslaer (2000). Horizontal inequit