Gimbe report shows 18 Italian regions met 2024 healthcare targets while 5.8 million forewent care

National evaluation and regional performance

The Gimbe Foundation released its 2024 assessment of Essential Levels of Care (LEA) across 21 Italian regions and autonomous provinces. The evaluation relies on 27 core indicators under the Nuovo Sistema di Garanzia across collective prevention and public health, district assistance, and hospital care. To achieve compliance, a regional health system must score at least 60 points out of 100 in each category, reaching a maximum combined score of 300 points. In 2024, 18 of the 21 territorial administrations met the compliance threshold set by the Ministry of Health. Piemonte ranked fourth nationally with 272 points, placing sixth in prevention, fourth in district care, and fifth in hospital care. Liguria achieved eighth place with 250 points, while Umbria placed seventh overall with 254 points.

Regional recovery and shifting scores

Multiple regional administrations recorded score increases compared to 2023. Valle d'Aosta gained 48 points to reach 213 points, exiting non-compliance to rank 14th nationally despite placing 20th in hospital services. Liguria increased its total by 31 points after failing to meet requirements in 2023, and Sardegna improved by 20 points to reach 212 points. Basilicata joined the compliant group by adding 16 points for a total score of 205, ranking 18th overall. Regional councillor for health Cosimo Latronico described the improvement as evidence of administrative stabilization:

This is a result that attests to the commitment and resilience of the regional health system and its personnel, despite a general context that still presents room for improvement.

Conversely, Umbria recorded a three-point decline, while Campania added three points to reach 209 points.

North-South divide and access barriers

The monitoring showed continuous differences in service delivery between northern and southern territories. Puglia recorded the highest performance in the south, placing 10th with 242 points after improving by 14 points vs 2023. Other southern regions gathered in the lower tier of the rankings, including Campania at 209 points, Basilicata at 205, Sicilia at 196, Molise at 192, and Calabria at 189. In the ministerial assessment, Calabria, Sicilia, and the autonomous province of Bolzano (206 points) were categorized as partially non-compliant. Gimbe Foundation president Nino Cartabellotta addressed the geographical distribution of scores:

With the exception of Puglia, all other southern regions are located in the lower part of the ranking or have at least one area barely above sufficiency. Formal promotions are therefore increasing, but the territorial divide remains clearly visible.

Healthcare renunciation and assessment criteria

Independent health monitoring revealed divergence between administrative compliance ratings and actual patient access to care. Gimbe reported that nearly 5.8 million Italian citizens renounced at least one prescribed medical visit or diagnostic examination in 2024. In Sardegna, Istat survey data showed that 23.9% of individuals receiving certain treatments and 8.7% of other residents forewent needed medical care. Cartabellotta stated that the ministerial benchmarks fail to capture whether citizens can access their statutory rights to healthcare:

If in 2024 almost all regions are promoted while private spending and waivers of healthcare services increase, we cannot conclude that healthcare has suddenly improved. Rather, it means that the ministerial report card has a very limited capacity to measure the actual accessibility of the LEAs by citizens.

Regional administrations including Basilicata indicated plans to invest in district and local healthcare facilities to close remaining service gaps.