Italy’s minister of health, Dr. Ferruccio Fazio, described his country’s efforts to increase efficiencies in the health system to ensure universal health coverage despite an aging population and growing economic constraints, during a visit to PAHO headquarters today.

Fazio noted that Italy has the second-highest life expectancy in the world: 85 years for women and 80 for men. The country’s health system, he said, can take at least partial credit for those figures. Italy provides free and full access to health care for all Italian citizens, at a cost of about 7 percent of GDP spent on health. Italy has adopted a number of measures to improve the efficiency of the system, including moving toward a primary health care approach and reducing the number of patients receiving care in hospitals.

The system focuses heavily on general practitioners (GPs) as “gatekeepers” and “group medicine,” in which GPs work alongside specialists in groups large enough to be able to provide care at least 12 hours, and preferably 24 hours, per day. GPs in the system provide patient follow-up through email and other ICTs.

The system also emphasizes large hospitals (250-300 beds or more) with advanced technologies for diagnosis and therapy, including transfusion services and intensive-care capacity. Smaller hospitals are assigned to provide only intermediate care.

Another feature of Italy’s system that promotes greater efficiency and better care, Fazio said, is that it is decentralized into 21 regions. These and other efficiency measures are not just ways to save money but help ensure better care overall, said Fazio.

“The best health systems are those that spend less. Not only is it not true you need a lot of money to provide good care, the best systems are that way because they are rationalizing expenses, not wasting money, using resources in an appropriate way.”