Is Health Care demand rationed by income and other determinants? An empirical assessment for Italy

The Italian national health service was funded in 1978 with the goal of providing uniform and comprehensive care under the inspiration of the Republic’s Constitution. It is important to assess to what extent the health service meets the potential demand of the population and if the socio-economic status of the patient - mainly income and education - may ration the access to healthcare. This paper offers an empirical assessment of the determinants of healthcare demand in Italy for a detailed range of services including diagnostic tests and hospital services, not often analyzed in the empirical literature. An econometric hurdle model is applied to individual microdata from a large-scale survey. From our results, some accessibility problems seem to arise for persons who have fewer alternatives in the private market - with lower income, less educated, not privately insured - and living in the Southern part of the country.