Report WHO on global health spending. The satisfaction of citizens in Italy expires
(by Nicola Simonetti) World Health Organization (WHO) report on global health spending has been published (Xu K, et al. Public Spending on Health: A Closer Look at Global Trends. WHO, 2019).
According to this report, global healthcare spending continues to grow, representing the 10% of global gross domestic product. This increase is particularly consistent in low- or middle-income countries, where growth settles at around the annual 6%, compared to 4% of high-income countries.
In medium and high income countries, healthcare costs incurred by governments are on average US $ 270 per person while in low-income countries they are around US $ 60 per person.
Governments contribute, on average, for 51% to health expenditure, while more than 35% is paid out of their own country by the citizens of each country, a percentage still considered too high by the WHO that denounces that 100 millions of people, every year, find themselves falling back into extreme poverty as a consequence of such expenses.
"Health is a right and it is necessary that all countries put among their priorities - said Agnes Soucat, Health Systems, Governance and Financing Director of WHO - the development of an efficient and cost-effective primary care system, as a first step to achieve universal health coverage ".
In Rome, in the meantime, the 19 last March, were considered, during the "Inventing for Life - Health Summit" the great priorities of public health at a global level in the perspective of the centrality of patients and the difficult balance between innovation and sustainability ( present the Nobel Peace Prize 2011 Ellen Eugenia Johnson Sirleaf).
A survey by the Piepoli Institute on the perception of Italian citizens in the health sector found that the majority of the population (57%) is satisfied with our National Health Service (in 2018, instead, the 65% was: a figure in decline, therefore) but asks to do more on waiting times and prevention and calls for more investments for cancer, cardiovascular and neurological diseases while access to treatment is still considered too uneven across the country.
The centrality of the patient remains the guiding criterion for identifying the priorities to be addressed and for measuring the effectiveness of health systems and their ability to respond to health needs.
The efforts of the National Health Service, according to the responses to the survey, must be, in order, the reduction of waiting times for examinations and interventions (79%) and the prevention of diseases (51%) followed by support for the vulnerable , such as low-income families, chronically ill, disabled (49%).
The answers underline the theme of equal access to health services: according to almost all the sample (97%) today living in some Regions rather than in others leads to unequal opportunities for access to innovative therapies. The consequence is that for the 64% of the sample in Italy people do not have rapid access to innovative therapies, in particular those for cancer (33%), neurological diseases (19%), cardiological diseases (16%).
Another critical aspect is the one concerning waiting times too long to have a first specialist visit (44%), to take the necessary diagnostic tests (37%), to receive therapy (22%) and to obtain a follow-up visit up (19%).
The family doctor is confirmed as a point of reference for the 49% of the interviewees and the 36% turns to the family doctor before contacting a specialist.
But it is precisely the family doctor, a key factor in the centrality of the patient, who is subject to limitations in the prescription of drugs: 81% of Italians would like the family doctor to be able to prescribe innovative drugs.
At the same time, the president of FOFI (Federation of Pharmacist Orders), Andrea Mandelli, declared that "once the need for intensive monitoring has ceased, and if we are not dealing with medicines reserved for hospital use, innovative drugs must also be able to be prescribed. and dispensed on the territory ... Continue for mere economic reasons to exclude from the family doctor's prescription drugs that have proved to be as safe as the traditional and more effective ones, or continue to follow, as in other cases, the route of direct distribution at the ASL, rather than in the pharmacies, first of all translates into discomfort for citizens and a possible deterioration in the quality of care. Unfortunately, the case of diabetes is not isolated, and we hope that also in this regard, the path of strengthening assistance in the area will be taken ”.
The Piepoli survey confirmed that the family doctor is considered the most reliable source for health information (60% of the interviewees), while the internet is only reliable for 14%.
The fake news remain perceived as a threat: well the 87% of the Italians believe that they are dangerous for the health of the people, and 1 interviewed on 3 has admitted to have believed at least once to a fake news. Vaccines (47%) the most popular area, followed by tumors (42%).
For the 83% of Italians, the sector in which it is most important to invest in to foster innovation is health, followed by education. Among the pathologies in which Italians would like to see greater investments, tumors are in first place, with as many as 69% of preferences, followed by cardiological diseases (28%) and neurological diseases (26%).