Un Servizio Nazionale per gli anziani non autosufficienti

The Italian elderly in need of care are about 2.9 million. This number will grow significantly in the coming years. The Italian government committed to adopt by spring 2023 “an organic reform of interventions for elderly in need of care” as part of its Recovery and Resilience National Plan. The study aims at contributing to the debate on how to implement this reform by providing original estimates and reflections on the lessons that can be learnt from other countries and the Italian NHS. In particular, the study aims at offering four main contributions: 1) An original estimate of public and private expenditure for interventions for the elderly, respectively equal to 15.48 and 10.21 billion euros; 2) An original estimate of the coverage rate, i.e. the number of elderly people who receive public assistance by type of service, which is approximately equal to 52%; 3) The main elements for the “organic reform”, which are: a) the establishment of a single, integrated and distinct pillar from the other areas of welfare, with a single national fund, unified access units and a national prevention policy; b) levels of care commensurate to health conditions; c) the promotion and enhancement of territorial experiences; d) direct private spending for the development of a professional sector; 4) Finally, a simulation of the public expenditure and coverage rate of the proposed system has been developed, showing how the proposed system can have a positive impact in terms of intensity and quality of assistance levels.