The home medical care market - Italy (2024)

1.2 The global market

The global medical home care market is experiencing rapid growth and transformation. In ****, the value of the market was estimated at about $***.** billion. The market is expected to continue to expand at a compound annual growth rate (***) of *.** percent from **** to ****, reaching a value of about $***.** billion by ****. This represents an increase of **% over the period.

Global Market Value of Home Medical Care World, ****-****, in US$ billion GrandViewResearch

The services segment dominated the market and holds the largest share of revenue, accounting for **.**% in ****. The services market is divided into skilled home health care and unskilled home health care. Skilled services are provided by healthcare professionals. Non-qualified services include non-medical home care provided to dependent patients and are classified as primary/personal care services. Increased medical spending associated with hospitalizations is expected to increase demand for skilled care.

By ****, the home health care market sees North America holding **.* percent market share, while the rest of the world accounts for **.* percent.

Market shares Home health care World, ****, in % GrandViewResearch

By ****, one in five Americans will be over the age of **. About ** percent of the U.S. population over the age of ** is expected to have one or more chronic conditions that ...

1.3 The Italian market

Integrated home care is understood as home care delivered according to an individual care plan through multidisciplinary and multi-professional patient care. It also includes home palliative care and cases of protected discharge. The care plan consists of the definition of an organized set of medical, nursing and rehabilitation treatments necessary to stabilize the clinical picture, limit functional decline and improve quality of life. In general, intervention activation hypotheses refer to the terminally ill, acute vascular accidents, severe fractures in the elderly, severe acute psychotic forms, rehabilitation of vasculopaths, acute temporarily disabling diseases of the elderly, and protected discharges from hospital facilities. During ****, *,***,***patients were cared for at home.

Between **** and ****, an increase of *.* percent was estimated for the value of the Italian market, from *.** billion euros in **** to *.** billion euros in ****. After a steady growth until ****, it declined in ****. However, there was a recovery in **** with a value of *.** billion, before a slight decrease to *.** billion in ****. For this graph, the turnover of companies under ateco code **.*, nonresidential social assistance for the elderly and disabled, was taken into account.

Italian Home Health Care Market Value Italy, ****-****, in € billion Istat, Companies Register

In Italy, the number of non-self-sufficient elderly, i.e., ...

1.4 Inflation suffered by the sector

During periods of inflation, the consumer medical services sector tends to react with a gradual increase in prices. This phenomenon is often a response to rising operating costs, such as staff salaries, medical supplies and health technology. The increase also reflects the need to maintain the quality and availability of services despite economic pressures. In addition, health care policies and government regulations can influence the speed and magnitude of these increases. In general, the industry seeks to balance affordability of services with economic sustainability in an inflationary environment.

Price index for consumer medical services for the whole community (***) - monthly data Italy, ****-****, index Istat

the price index for consumer medical services in Italy, with base ****=***, shows steady growth from June **** to May ****. From a value of ***.* in June ****, the index increases to ***.* in May ****, showing an overall increase of *.* percent. The highest value is recorded in May **** with ***.*.

The coronavirus epidemic has affected the market in several ways. People involved in the home health care market are by definition the most vulnerable to the virus, so countries have had to develop appropriate responses to protect them. During the Covid-** emergency, home care services were enhanced in order to limit the ...

2.1 Main determinants of demand

The main driver of the home health care market is clearly the progressive aging of the population, a consistent trend in countries of the Western world over the past decades. Italy is one of the countries where life expectancy is among the highest in Europe and one of the countries with the highest share of the population over ** years old. In ****, only **% of the total Italian population was over ** years old, while in ****, this figure reached almost **%, and is expected to grow steadily until **** .

Evolution Population aged ** and older, percentage of total population Italy, **** - ****, in percent Source: ****

Average monthly household expenditure, ateco code [***], showed considerable variability, starting at *.** euros in ****, peaking at *.** euros in ****, followed by a significant drop to *.** euros in ****. In ****, spending increased slightly to *.** euros, before falling further to *.** euros in ****. Overall, spending decreased by **.* percent from **** to ****. For ****, under the same Istat research name but different ateco code [***], the average monthly household expenditure is €*.**. They most likely contain different product categories. Average monthly household expenditure on home care services Italy, ****-****, in current &euro Istat

The majority of patients cared for at home are people over **, accounting for **.* percent of the total. Terminal patients make up ...

2.2 Characteristics of the Application

Statistics of home health care in ****(***). Region Number x ***,*** population of which Elderly (***) Seniors per *,*** elderly residents (***) of which Terminal Patients (***) Terminal Patients per *,*** residents PIEDMONT ***** **** ** **.* ** *.* VALLE D'AOSTA **** **** **.* **.* **.* *.* LOMBARDY ****** **** **.* **.* *.* *.* PROV. AUTON. BOLZANO **** **** **.* **.* **.* *.* PROV. AUTON. TRENTO **** **** ** **.* **.* *.* VENETO ****** **** ** ***.* **.* *.* FRIULI VENEZIA GIULIA ***** **** **.* **.* *.* *.* LIGURIA ***** **** ** **.* ** * EMILY ROMANIA ****** **** **.* ***.* *.* *.* TUSCANY ****** **** **.* *** *.* *.* UMBRIA ***** **** **.* **.* *.* *.* MARCHE ***** **** **.* **.* *.* *.* LAZIO ***** **** **.* **.* *.* *.* ABRUZZO ***** **** **.* **.* *.* *.* MOLISE ***** **** **.* ***.* *.* *.* CAMPANIA ***** **** **.* ** ** *.* PUGLIA ***** **** **.* **.* **.* *.* BASILICATA ***** **** **.* **.* ** *.* CALABRIA ***** *** **.* **.* **.* * SICILY ***** **** **.* **.* *.* *.* SARDINIA ***** **** **.* **.* **.* *.* ITALY ******* **** **.* **.* *.* * Average hours per case in home care varied significantly by type of care. Physicians recorded the highest number with **, followed by nurses with ** hours. Other caregivers and rehabilitation therapists contributed * and * hours per case, respectively. A total of ** hours were devoted to each elderly case, while for each terminal patient the total was **, showing a higher intensity of care for terminal patients than for the elderly. Hours Treated by Type of Home Care Italy, ****, in average hours per case Source: ****

2.3 Application for CIA intakes

One of the ways in which the state provides home care services is through what is called ADI. This has four different levels of care intensity, which is measured in terms of the Coefficient of Care Intensity(***) and specialist level palliative care, delivered by specialized staff and characterized by a CIA greater than *.**.[***]

In detail, over the year ****, of the *,***,*** Presa In Carico intended for individuals aged ** or older, we note ***,*** cases with the minimum degree of care intensity (***), ***,*** cases framed in the first level of CIA, ***,*** cases in the second level, **,*** in the third and ***,*** in the fourth. Finally, of note is the large increase in episodic home visits, which number ***,*** cases of CIP, a significant jump from ***,*** in ****.

Percentage distribution of the number of Intake by CIA, Italy, ****, as a percentage of total intakes Source : Italia Longeva * In this case, the date of first and last access coincide

2.4 Geographical distribution of demand

The following map shows the geographical distribution of average household spending on medicines and health products in ****:

In the following instead, the cases handled for home care are analyzed:

2.5 Online interest in home health care

Searches for home health care in Italy show a variable trend with peak and trough trends. The initial value of ** in June **** peaked at ** in March ****. From there, searches declined, stabilizing around **-** in the following months. The ***.* percent increase between the minimum value in August **** (***) and the peak in March **** shows considerable interest during this period. Thereafter, despite the fluctuation, the level of interest remained relatively high compared to the initial values.

Trends in home health care searches Italy, ****-****, index Google Trends, Businesscoot elaboration

The trend of home health care searches by region in Italy shows significant variations. Sardinia records the highest value with an index of ***, followed by Molise with **. Lazio and Calabria stand at ** and **, respectively. Regions such as Umbria, Abruzzo, and Basilicata show intermediate values around **-**. Lombardy, Tuscany, and Emilia-Romagna have lower values, around **. Valle d'Aosta and Trentino-Alto Adige close the list with the lowest indices of ** and **.

2.6 New demand trends

In recent years, the demand for home health care has shown several new trends:

Technology and Telemedicine: The adoption of advanced technologies and telemedicine services is growing. Patients and healthcare professionals are taking advantage of remote monitoring devices and virtual consultations, improving the accessibility and quality of home care. Personalization of Services: There is a growing preference for personalized services that are tailored to specific patient needs. This includes individualized and flexible care plans that consider unique health conditions and personal preferences. Cost-Effectiveness: As hospital costs rise, home care is seen as a more cost-effective option. Families and health systems value home care as an option that can reduce costs without compromising quality of care. MentalHealth and Psychological Support: The pandemic has highlighted the importance of mental health, and there is a growing demand for psychological support services at home. Mental health professionals offer counseling and therapy directly in patients' homes. Rehabilitationand Recovery: After surgery or serious illness, many patients prefer to continue rehabilitation at home. Physical therapy and home rehabilitation services are becoming increasingly popular. Support for Family Caregivers: As responsibilities for family caregivers increase, there is a greater demand for services that offer support and temporary relief, allowing caregivers ...

3.1 Market structure

The number of active enterprises in Italy in non-residential social care for the elderly and disabled showed an overall growth of *.* percent, from *,*** to *,***. After a steady increase from **** to ****, peaking at *,*** enterprises in ****, the number dropped slightly in **** to *,*** and further to *,*** in ****, then stabilized in **** at *,***.

Number of active enterprises for 'non-residential social care for the elderly and disabled Italy, ****-****, in number Istat

Analysis of the Nonresidential Social Assistance Market in Italy:

Legal form of enterprises active in 'non-residential social assistance for the elderly and disabled Italy, ****, in % Istat

In ****, enterprises active in nonresidential social assistance for the elderly and disabled in Italy were mainly social cooperative companies, accounting for **.** percent of the total. Sole proprietors, freelancers and the self-employed made up **.** percent, while limited liability companies were *.** percent. Other legal forms were less common: cooperative societies excluding social societies (***). These data indicate a predominance of cooperative structures.

Evolution of Personnel in Nonresidential Social Assistance in Italy:

Number of staff working in non-residential social assistance for the elderly and disabled Italy, ****-****, in thousands Istat

Between **** and ****, the number of workers operating grew by **.* percent, from **.* thousand to ***.* thousand. After a steady growth from **** to ****, peaking at ***.*, the ...

3.2 Value Chain

*. Assessment of Patient Needs

Initial Assessment and Referral:

A health care professional performs a comprehensive assessment of the patient's needs, reviewing medical history and current condition. The patient is referred by a physician, hospital or other health care facility, determining eligibility for home care services.

*. Care Planning

Development of the Personalized Care Plan:

Based on the initial assessment, a tailored care plan is created that details the services needed, health goals, and frequency of visits. The care plan is discussed and agreed upon with the patient and family members to ensure involvement in decision-making.

*. Care Coordination

Staff Assignment and Scheduling:

Appropriate health care personnel, including nurses, physical therapists, physicians, and home care aides, are selected and assigned. Home visits are scheduled in accordance with the care plan, ensuring continuity and consistency in the care provided.

*. Delivery of Services

Provision of Care:

Medical and Nursing Care: Provision of clinical care, medication management, dressings, monitoring of vital parameters and specific treatments. Rehabilitative Therapies: Performing physiotherapy sessions, speech therapy and other necessary rehabilitative therapies. Support in Daily Activities: Assistance with daily activities such as personal hygiene, meal preparation and mobility. Psychological Support: Offering counseling and emotional support for the patient and ...

3.3 Geographic Distribution of Health Authorities Offering Home Health Care

Geographically, the region that has offered the most Integrated Home Care is Piedmont with ** Health Authorities, followed by Latium with ** and Sicily and Veneto with *. A total of *** Health Authorities have offered this type of service.

Regarding the totality of home medical services offered, three main organizational models can be found among the Health Authorities:

*) The ADI provided exclusively by the Health Boards, in which *** percent of the activities are provided by the District using in-house staff in full.

*) The ADI provided exclusively by private companies, in which ***% of the services are provided by profit and nonprofit managing entities, which implement the IAP formulated by the District or are chosen by the citizen himself.

*) Mixed Model in which there is a division of services between District and private managing entities.

The division between the various organized models varies greatly by region and sometimes even within the same region. Bergamo has *** percent private providers, followed by Milan, with ** percent of the total, Salerno (***).

In the following table it is possible to get an idea of the number and type of private providers for some ASLs, ATSs and ASPs scattered throughout Italy[***].

3.4 The main players in the market

We will divide the market into * sectors:

Medical Device Manufacturers and Equipment Providers Providers of Home Care Services

The main manufacturing companies are:

Medtronic PLC: It is one of the leading global companies in the health technology sector, headquartered in Dublin, Ireland. Founded in ****, the company develops and manufactures medical devices used in various medical specialties. Its main segments include cardiovascular devices, neuroscience, medical surgery and diabetes solutions. It is known for innovation in the medical industry, investing about $*.* billion in research and development in ****. Its products range from pacemakers and cardiac defibrillators to continuous glucose monitoring systems and insulin pumps. The company serves more than ** million patients a year, with the goal of relieving pain, restoring health and prolonging life. Led by CEO Geoff Martha, it has more than **,*** employees and operates in more than *** countries. Its mission is to provide healthcare solutions that improve the lives of patients around the world.

Baxter International Inc: Headquartered in Deerfield, Illinois, was created in ****, Baxter develops and supplies a wide range of health care products used in hospitals, kidney dialysis centers, nursing homes, and physician practices. The company operates through four main segments: medical products and therapies, healthcare systems and technologies, pharmaceuticals, ...

4.1 Type of services

Type of Service Description Main Beneficiaries Home Medical Visits General practitioners and specialists visit patients at home for diagnosis, treatment and monitoring. Patients with reduced mobility, chronic diseases, need for frequent visits. Telemedicine Medical consultations via video calls, with the possibility of receiving advice and prescriptions. All patients, especially those in remote areas or with travel difficulties. General Nursing Nurses administer medications, perform injections, manage wounds and monitor vital signs. Post-operative patients, those with chronic diseases, the elderly. Skilled Nursing Nurses with specialized skills manage complex treatments such as intravenous therapy and mechanical ventilation. Patients with complex conditions and advanced care needs. Physical Therapists Physical therapists help regain mobility and function through specific exercises. Patients in post-surgical rehabilitation, trauma, stroke. Occupational Therapy Therapists improve skills necessary for daily living, such as dressing and eating. Patients with physical or cognitive disabilities. Speech Therapy Speech therapists support patients with speech and swallowing difficulties. Patients with communication or swallowing problems. Psychological Support Psychologists provide emotional and psychological support to patients and their families. Patients with mental conditions, stress, anxiety, depression. Social Work Assistance Social workers help navigate the health care system and access community resources. Patients with complex social and financial needs. Personal Care Home ...

4.2 The prices

The rising cost of care has been steady in recent years, forcing providers to raise rates and consider diversifying payment sources outside of private care. According to Genworth, by **** the cost of a home care aide has increased by ** percent, reaching an average annual cost of more than $**,***. Home care services-which include less direct care-also increased by *.* percent, reaching a median annual cost of more than $**,***. Assisted living costs increased by only *.* percent, skilled nursing care by *.* percent and private rooms in nursing homes by *.* percent. Analyzing this year's data, costs have increased, but not as dramatically as in previous years, especially for assisted living facilities, which increased only *.* percent from **** to ****, but overall by **.* percent from **** to ****. This is due to inflation and housing market trends stabilizing after the pandemic. With **,*** people turning ** every day until ****, and seven out of ten of them likely to need long-term care services sooner or later, the demand for skilled workers in the long-term care sector is increasing. However, prices have not stabilized in home care, which has changed providers' attitudes. As Medicaid rates for personal care became more affordable during the pandemic, many home care providers shifted toward providing state-sponsored care. In some ...

4.3 The development of telemedicine

The development of telemedicine has had a major impact on the field and deserves special attention. This term refers to the use of digital information and communication technologies, such as computers and mobile devices, to access health services remotely and manage health care. This is a segment of e-health that is growing strongly in Italy and had a spending level of *.* billion euros marking a slight increase from *.* billion euros in ****, or about ** euros per inhabitant per year [***].

Spending on telemedicine in Italy was estimated at ** million euros in **** and includes telemedicine software, videoconferencing equipment, communicating video devices, IT integration/consulting service, telemedicine service, and assessment service.

At the same time, physicians' interest in these new technologies, which they use mainly to communicate with patients, is also growing. Whatsapp, for example, is used by ** percent of family physicians and ** percent of specialists, mainly to easily exchange data, images and information. Citizens are less digital: only ** percent use email, ** percent use text messaging, and ** percent use Whatsapp to communicate with their doctor. This is not to mention the time savings that more widespread use of medicine would bring to users. In the past year, * out of ** Italians picked up medical records in ...

4.4 New trends

The market is undergoing a major revolution, also aided by the effect of Covid on the industry. The development of the Internet of Things (***), a neologism for objects gaining "intelligence" through the ability to be able to communicate data and access external information, is playing a primary role in the digitization process of the industry. Or again, the development of radio frequencies and artificial intelligence applied to the sector with the aim of ensuring constant and reliable monitoring of all behaviors kept by frail individuals, who in this way can easily stay connected with caregivers and family reference figures.

Several Italian staert-ups are active in the sector including:

Advanced Technology: Artificial intelligence (***) can analyze huge amounts of data to predict health problems and suggest early interventions, while robotics are beginning to make their way into patients' homes. Robot assistants can help with mobility, medication administration and other daily needs, greatly improving the quality of life for people with reduced mobility. Ergotex , which has developed a smart chair that can assess a patient's posture and facilitate sitting. Its pressure sensors and related data processing module are made to prevent incorrect and potentially dangerous postures. my Doro Manager: thanks to this, the elderly ...

5.1 Regulation

The National Health Service (***).

The care aims to stabilize the clinical picture, limit the functional decline and improve the quality of life of the person in his or her familiar environment, avoiding, as far as possible, the use of hospitalization or in a residential facility. In any case, the ASL ensures continuity between hospital care and territorial home care.

The request for activation of home care can be submitted by anyone (***) to the relevant offices of the ASL, usually located at the District.

When the dependent person occasionally needs the professional services of the doctor, nurse or rehabilitation therapist, even repeatedly over time, in response to a health need of low complexity, (***), it is called basic level home care.

If the patient has a more complex health condition, the NHS provides a care pathway that includes:

multidimensional assessment of needs in terms of clinical (***), through appropriate standardized and uniform tools and scales; drafting an "Individual Care Plan" (***) that describes the services needed, how they will be carried out and the duration of treatment. The general practitioner or pediatrician of free choice has clinical responsibility for the care processes, valuing and supporting the role of the family. taking charge of the patient ...

5.2 The enhancement of home care through the NRP

The National Recovery and Resilience Plan is the plan approved in **** by Italy to revive its economy after the COVID-** pandemic to enable the country's green and digital development. The total amount of money paid by the EU to Italy will be ***.* billion euros. The plan is divided into several missions, and mission * of the plan allocates some of this money to health.

Within mission *, three billion is earmarked for the strengthening of home care for the elderly. The investment in the plan aims to increase the volume of services rendered in home care to the point of taking care of ** percent of the over-**s by mid-****. The main recipients of this action will be the elderly with one or more chronic and/or dependent conditions.

Another *** million will finance the conversion of RSAs, the assisted living residences, with the aim of increasing in the territory autonomous and equipped apartments for the elderly with disabilities. The goal is to have them also taken over by social services, so that they can be cared for and helped in their daily needs. In Italy, there are ***,*** elderly guests in social welfare and social-health residential facilities, ***,*** of whom are non-self-sufficient (***). There are *.* beds ...

6.1 Segmentation

• Medihospes
• Operatori Sanitari Associati
• Cooss Marche Onlus
• Ancora Servizi
• Home Instead
• Amedisys
• Brookdale Senior Living
• Medtronic PLC
• Baxter International Inc
• B. Braun Melsungen AG
• 3M Healthcare
• F. Hoffmann - La Roche AG