Lea (essential levels of assistance) show the result of an Italy that, on health, is divided in half: only 13 regions have been promoted, the same number of 2022.
These are the results of the 2023 report published by the Ministry of Health on the monitoring of the fundamental care that all regions must guarantee free of charge or with tickets.
Healthcare, regions promoted and rejected
The Gimbe Foundation analyzed the ministerial report to make it a summary. The relationships on the Lea are, so to speak, report cards of Italian health that show what are the fulfilling regions and the defaulting regions.
From 2020 the tool used has been called NSG (new guarantee system), which provides 88 indicators divided into three areas:
- collective prevention and public health;
- district assistance;
- Hospital assistance.
However, the official “report card” uses only 26 indicators. To be promoted, a region must obtain at least 60 points in each area.
In 2023 they were fulfilled regions: Campania, Emilia-Romagna, Friuli Venezia Giulia, Lazio, Lombardy, Marche, autonomous province of Trento, Piedmont, Puglia, Sardinia, Tuscany, Umbria and Veneto.
Campania and Sardinia are among the promoted, while Basilicata and Liguria relegate. They remain defaulting for insufficiency in a single area Calabria, Molise and province of Bolzano, while Abruzzo, Sicily and Valle d’Aosta do not reach the threshold in two areas. The Aosta Valley, in particular, stands at the bottom of the ranking.
The photograph is clear: out of 13 regions promoted, only three belong to the South. Puglia has performances similar to those of the North, but Campania and Sardinia stop just above enough.
Healthcare, Lea Lea year 2023
Since the ministerial report card does not provide a single score, the Gimbe Foundation has developed an independent ranking, adding the scores of the three areas.
The result accentuates the geographical gap: among the top ten regions six are in the North, three of the center and only one of the South. The last seven positions, apart from the Aosta Valley, are all occupied by southern regions.
Some regions (such as Veneto, Emilia-Romagna and Tuscany) are positioned uniformly in the three areas, reporting balanced health. Others (such as Calabria, Liguria and Bolzano) show serious internal imbalances: they work well in the hospital but bad in the area, or vice versa.
Health, who goes up and who descends
Compared to 2022, eight regions worsen their performances. The most relevant falls concern Basilicata (-19 points), Lombardy (-14), Sicily (-11) and Lazio (-10).
This is the comment by Nino Cartabellotta, president of the Gimbe Foundation:
The reduction of performance also in historically solid regions – comments Cartabellotta – shows that the SSN estate is no longer guaranteed even in the territories with greater availability of resources or health reputation. It is an alarm bell that cannot be ignored.
Two regions of the South stand out on the opposite front: Calabria (+41 points) and Sardinia (+26). The signal is positive, but still insufficient to fill the national gap.
Lea to reform?
Ministerial monitoring, warns Gimbe, risks flattening real differences. The indicators are few and the too low sufficiency thresholds. For this reason Cartabellotta proposes:
- an expansion of the number of indicators used;
- a periodic rotation of the evaluation criteria;
- A review of return plans and commissioners, which have improved the budgets but not the quality of assistance.
