An Assessment of Effects of Socioeconomic Status, Employment
Type, and Employee Benefits on Italian Healthcare Access and Delivery in Milan
Survey
Italian Translation
14
16FM
Survey Sample
20-30 30-40 40-50 50-60 60-700
1
2
3
4
5
6
7
8
9
10
9
7
4
6
4
Sample Pool by Age Group
Government Private Sector Self Employed0
2
4
6
8
10
12
14
16
18
20
7
19
4
Survey Sample Pool
a. Less than 500
b. 500-1000
c. 1000-1500
d. 1500-2000
e. 2000-2500
f. 2500-3000
g. 3000-3500
h. 3500-4000
i. Over 4000
0
1
2
3
4
5
6
7
8
9
10
3
5
9
3
1 1
4
2 2
Sample Pool by Income Level
a. Less than 500
b. 500-1000 c. 1000-1500
d. 1500-2000
e. 2000-2500
f. 2500-3000 g. 3000-3500
h. 3500-4000
i. Over 40000
0.5
1
1.5
2
2.5
3
3.5
1 1
2
1
2
3 3
1 11 1
2 2
1 1
2
1
2
1 1
Income vs. EducationAssociate's
Bachelor's
Doctorate
High School
High School
Master's
Research Results
Quality of Care
0
5
10
15
20
25
30
6
9
13
7
24
21
16
23
1
Quality of CareNo
Yes
No Answer
Satisfied with Primary Care Physician Choices?
Satisfied with Specialists Choices?
Broad Range of Services Offered?
Time Spent Adequate?0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
20%
30%
43%
23%
80%
70%
53%
77%
Quality of Care
No Yes
Access to Care
Primary Physician Care Specialist Care Diagnostic Tests0
5
10
15
20
25
23
2120
7
9
10
Access to CareChallenges Faced While Seeking?
No Yes
Primary Physician Care Specialist Care Diagnostic Tests0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
77%
70%67%
23%
30%33%
Access to CareChallenges Faced While Seeking:
No Yes
Wait Period for Physician Appointment: Average: 11.94 days Max: 90 days Min: 0 days
Wait Period in Physician’s Clinic: Average: 2.52 hours Max: 12 hours Min: 30 minutes
Access to Care
Cost of Care
Out of Pocket Pay? Out of Pocket Pay Significant?0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
41%
76%
59%
24%
Cost of CareNo Yes
Opinions on Insurance Systems
Satisfied with Public Insurance? Purchase Private if More Options?0%
10%
20%
30%
40%
50%
60%
70%
80%
27%
53%
73%
47%
Insurance OptionsNo Yes
Major Observations:In Conjunction with Income
Levels
A greater number of individuals with monthly incomes lower than €2000 thought that public health insurance did not provide a broad range of services than did individuals with monthly incomes higher than €2000 (29.17% vs. 15.56%)
Quality of Care
A greater number of individuals with monthly incomes lower than €2000 faced challenges in seeking primary physician care than did individuals with monthly incomes higher than €2000 (13.33% vs. 8.89%)
A greater number of individuals with monthly incomes lower than €2000 faced challenges in seeking specialist care than did individuals with monthly incomes higher than €2000 (21.67% vs. 8.89%)
A greater number of individuals with monthly incomes lower than €2000 faced challenges in seeking diagnostic tests than did individuals with monthly incomes higher than €2000 (25% vs. 10%)
Access to Care
Individuals with monthly incomes lower than €2000 spent SIGNIFICANTLY more time on an average waiting for a physician’s appointment than did individuals with monthly incomes higher than €2000 (10.9 days vs. 1.43 days)
Individuals with monthly incomes lower than €2000 spent SIGNIFICANTLY more time on an average waiting their appointment at the doctor’s clinic than did individuals with monthly incomes higher than €2000 (2.23 vs 0.44 hours or 134 vs. 27 minutes)
Access to Care
A greater number of individuals with monthly incomes lower than €2000 made out of pocket contributions to healthcare than did individuals with monthly incomes higher than €2000 (45.85% vs. 13.33%)
These out of pocket contributions were more likely to represent a significant portion of the take-home income for individuals with monthly incomes lower than €2000 than for individuals with monthly incomes higher than €2000 (16.67% vs. 0%)
Cost of Care
A greater number of individuals with monthly incomes lower than €2000 were satisfied with the public health insurance system than were individuals with monthly incomes higher than €2000 (50% vs. 24.44%)
A greater number of individuals with monthly incomes lower than €2000 were open to purchasing private insurance if it translated to more coverage options and more efficient care than were individuals with monthly incomes higher than €2000 (26.67% vs. 17.78%)
Opinions on Health Insurance Systems
“We don’t have insurance here.”
“I would be willing to buy [private] health insurance only if I wouldn't deposit [more] money to the state, as the taxes that I pay are much more than enough. Unfortunately, [not purchasing one] affects our [healthcare options].”
“[Our system] doesn't [allow you to see the same] professional doctor for specialist care. [Therefore, there is] discomfort with the continuity of care.”
Additional Comments
Regional Disparity High quality service within public healthcare
framework in the North Not the same story in the South, hence push for
private coverage
Non-emergency care wait times long across the nation Example: cataract surgery wait times around 9-12
months
Interview w/ Dr. Stefano Rusconi
Some Pictures