ABSTRACT
Italy’s healthcare system is a regionally-based National Health Service (INHS) that provides universal coverage. Services are free of charge at delivery and this gives rise to several forms of non-price rationing. Quality and safety are considered major policy concerns even in a period, as is currently the case, in which the public healthcare system is suffering from a striking economic and financial crisis. Many healthcare reforms have been launched since the establishment of the INHS in 1978, with the aim of setting structural, professional, and technological standards, managing quality, and assessing performances. Along with healthcare reforms both at the national and regional level within the public system, several emergent initiatives have been promoted at a local level. These are currently in place and promote quality and safety in the whole healthcare sector. Nevertheless, in this scenario, quality and safety assurance in the healthcare system could be improved in the near future by implementing policies that fill some of the existing gaps. A greater involvement of patients and citizens in assessing the performance of the system, a clearer link between publicly available evidence and policymaking, the establishment of a national framework for health technology assessment, and the definition of organizational standards for hospitals and other healthcare services are major priorities for the INHS.
