by Alessandra Cardone
ROME, Dec. 11 (Xinhua) -- Accessing medical treatments through Italy's National Health System (SSN) has become more difficult in 2017 compared to the previous year, a survey based on citizens' claims suggested on Tuesday.
Some 37.3 percent of those involved in the survey said they were not able to receive the necessary assistance in due time in public health facilities last year, against 31.3 percent in 2016, the report PiT Health by civil group Cittadinanzattiva (Active Citizenship) showed.
Titled "The future of healthcare at stake", this was the 21st such survey carried out by the association, based on 20,163 claims received by citizens between Jan. 1 and Dec. 31, 2017.
The major inconvenience emerging from such claims concerned the waiting list for specialized medical examinations and treatments, which was reported as top problem by 56 percent compared with 54.1 percent in the previous year.
On average, people claimed they had to wait up to 12 months for an ultrasound scan in public hospitals, 13 months for a mammography, some 10 months for a computerized axial tomography (CAT), and 9 months for a Doppler ultrasound.
The report further highlighted a concerning 4.8 percent annual increase in the number of people complaining about a too long wait to access chemotherapy and radiotherapy against cancer.
The long-wait complaints for overall surgeries in the SSN also grew by 1.9 percent year-on-year, according to the PiT Health.
However, the survey also reported an improvement in terms of waiting list for diagnostic tests, showing a 5.6 percent drop in terms of number of claims in 2017 against 2016.
The second issue most often reported was the difficult access to so-called territorial assistance, which in Italy comprises health services provided at home and in facilities other than hospitals. This was a major problem for 14.9 percent of people turning to Cittadinanzattiva in 2017, up from 13.9 percent in the previous year.
In terms of number of claims, these two issues were followed by a lack of assistance for disabilities (12.2 percent), alleged malpractices (9.8 percent), lack of information (8.8 percent), and problems related to drugs (3.4 percent), among others.
The report also considered the costs spent by citizens to access public healthcare last year, and how these might have hampered their chance to receive the necessary assistance.
Some 30.3 percent said the cost of therapies or exams was the heaviest for them, followed by 23.8 percent complaining for the cost of drugs, and 14.6 percent for that of services within hospitals.
The share of people protesting for these same costs had been 33.8 percent, 19.4 percent, and 13.0 percent in the 2016 survey, respectively.
The Italian national healthcare is regionally based, and provides free universal coverage, yet with a cost-sharing mechanism that requires a contribution from the citizen according to income and age.
Figures from the National Institute of Statistics (ISTAT) showed the healthcare expenditure was equal to 8.9 percent of the country's gross domestic product (GDP) in 2016, some 75 percent of which was provided by public funds.
The sole public spending for the healthcare system that year was 112 billion euros (126.7 billion U.S. dollars), ISTAT added. It remained one of the lowest among the countries of the Organization for Economic Co-operation and Development (OECD).
Despite coming under increasing strain in latest years due to austerity cuts and a larger share of elderly population to assist, the Italian SSN rates among the world's most efficient ones.
The World Health Organization (WHO) placed it in the second place after France's in its global ranking of healthcare systems in 2000. A more recent comprehensive study by medical journal The Lancet put it in the 11th place in a ranking of healthcare quality in 2015.
Despite this overall good performance, relevant imbalances in the quality of assistance were still reported across the 20 Italian regions, with a major rift being marked by the traditional north-south divide.
In its second-to-last report in 2016, the National Observatory on Healthcare with Milan-based La Cattolica University stressed that "the Southern question has not yet been resolved."
"To mention just some numbers -- the Observatory noted -- national per-capita health expenditure in 2015 was 1,838 euros on average, yet much higher in the (far northeast) Autonomous Province of Bolzano (2,255 euros), and significantly lower in Southern Italy, especially in Calabria (1,725 euros)."