title: [Prevention in times of economic crisis and spending review. The Lazio Region as a study case].
abstract: With cutbacks being implemented across a wide range of social and government programs throughout Europe and the rest of the world, preventive services have become more vulnerable. In this context, it is essential to properly focus the debate on public healthcare expenditure, stressing that financing preventive services is not merely a cost, but an investment in citizen well-being as well as economic stability and development. In Italy indeed all seem to agree on three priorities: i) strengthening prevention activities; ii) reorganization of hospital care; and iii) reinforcement of primary care. A plenty of data are available in Italy from some recently published authoritative reports. Given that health policies should be driven by a solid evidence base, it is important to look at the available data to understand if these priorities are justified. The Lazio Region, which is particularly under pressure since it is one of the regions with a formal regional recovery plan (Piano di Rientro), was chosen as a case-study. In the Lazio Region public health care expenditure is particularly high, but the health care expenditure for prevention activities is among the lowest of the Italian Regions. Major weakness points documented by the essential levels of care indicators included recommended vaccinations coverage, oncological screening programs, residential beds for the elderly and persons with disability and hospital care efficiency. Avoidable mortality is higher in the Lazio than in the rest of the country, as well as the prevalence of some major behavioral risk factors. Even if all data available support the choice to consider prevention activities as a priority, it is essential to increasing the value of prevention, investing money in preventive interventions of proven effectiveness and cost-effectiveness and promoting synergies with institutions outside the health care sector, implementing in a more efficient way the principle of Health in All Policies.
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma.
authors.forename: Marco
authors.initials: M
authors.lastname: Di Marco
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma.
authors.forename: Carolina
authors.initials: C
authors.lastname: Marzuillo
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma.
authors.forename: Corrado
authors.initials: C
authors.lastname: De Vito
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma.
authors.forename: Azzurra
authors.initials: A
authors.lastname: Matarazzo
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma.
authors.forename: Azzurra
authors.initials: A
authors.lastname: Massimi
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma.
authors.forename: Paolo
authors.initials: P
authors.lastname: Villari
mesh_terms: D057172:Economic Recession; D005102:Health Expenditures; D006801:Humans; D007558:Italy; D011314:Preventive Health Services / Q000191:economics*
vernacular_title: La prevenzione in tempi di crisi economica e di spending review. Il caso della Regione Lazio.