ArticleBMJ open2023
Changes in private health service utilisation and access to the Italian National Health Service between 2006 and 2019: a cross-sectional comparative study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Prevalence of hearing loss and tinnitus among school-age children: a cross-sectional analysis of the PICTURE cohort study.Frontiers in public health · 2026Article
- Patients' Attitude toward Less Frequent Surveillance of Low-Risk Pancreatic Cysts: A Multicenter European Cohort Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Observational
- Twenty-year trend in comorbidity score among adults aged 50-85 years in Lombardy, Italy: Age-Cohort-Period analysis and future trends.BMJ open · 2025Observational
- Reforming Italy's long-term care system: the role of barriers to and drivers of the use of services at the local level.Frontiers in public health · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPrevious research highlighted that in the early 2000s a significant share of the Italian population used and paid out of pocket for private healthcare services even when they could potentially have received the same treatments from the National Health Service (NHS). The decrease in public investments in healthcare and the increase in health needs due to the population ageing may have modified the use of private health services and equity of access to the Italian NHS. This study aims to investigate the change in the prevalence of individuals who have fully paid out of pocket for accessing healthcare services in Italy between 2006 and 2019 and the main reasons behind this choice.
designCross-sectional comparative study. PARTICIPANTS AND COMPARISON: Two representative samples of the Italian population were collected in 2006 and 2019. OUTCOME MEASURES: Prevalence of access to fully paid out-of-pocket private health services; type of service of the last fully paid out-of-pocket access; main reasons for the last fully paid out-of-pocket access.
resultsWe found an increase in the prevalence of people who declared having fully paid out of pocket at least one access to health services during their lifetime from 79.0% in 2006 to 91.9% in 2019 (adjusted OR 2.66; 95% CI 1.98 to 3.58). 'To avoid waiting times' was the main reason and it was significantly more frequent in 2019 compared with 2006 (adjusted OR 1.75; 95% CI 1.45 to 2.11).
conclusionsThis comparative study, conducted the year before the outbreak of the COVID-19 pandemic, highlighted an increase in the prevalence of Italian residents who have fully paid out of pocket for access to health services to overcome long waiting times. Our findings may indicate a reduced access and possible worsening of the equity of access to the public and universalistic Italian NHS between 2006 and 2019.
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