Health expenditure for prevention in Italy (2006-2013): descriptive analysis, regional trends and international comparisons

We systematically assess and critically appraise Italian national and regional-level data on health expenditure for prevention in the period 2006-2013, expanding on international figures available from the Organisation for Economic Cooperation and Development (OECD) reports. At the national health system level, as emerges from the health expenditure monitoring system of the Italian National Agency for Regional Health Services (Agenas), in Italy public health expenditure for prevention accounts for about 4.2% of total public health expenditure (4.9 billion euros in 2013); these figures being constant over the study period. Expenditure for preventive services targeting individuals (i.e., immunization and screening) has increased over time (+8.7%), while public hygiene and veterinary expenditure has decreased (-5.7 and -3.8%, respectively). International comparisons, which consider different parameters, report Italy to spend 2.9% of total health expenditure on prevention, which is in line with the OECD Countries average. In Italy expenditure for prevention is still below the 5% national target, with a lot of heterogeneity by region. In the context of a health system that still provides universal health coverage, increased resources should be devoted to plan and implement preventive programmes of proven efficacy and cost effectiveness.