The nursing home market - Italy

1.2 A growing global market

In ****, The global skilled nursing facility market, which includes nursing homes, was valued at $***.** billion, instead $***.* billion in ****. Themarket value is projected to reach $***.** billion by ****, with a recorded CAGR of *.*% during the **** - **** forecast period.

Valore Mercato Mondiale delle strutture infermieristiche qualificate Mondo, **** - ****, in miliardi di dollari Fonte: Precedence Research

The growing demand for nursing homes is mainly due to the increasing elderly population in many countries around the world. National Institute estimates that the population aged ** and older makes up *.* percent of the global population. In addition, the geriatric population is expected to reach * billion by ****, again globally.

The second main driver of market growth is related to the prevalence and spread of chronic diseases, such as heart problems, Alzheimer's disease, cancer, diabetes, and dementia. Finally, other factors can be identified as increasing life expectancy and care needs of the elderly.

The market among different geographic areas of the world

The strong demand for nursing homes especially in developed countries such as North America, followed by Europe, has strongly contributed to the growth of the assisted living market in the past years. According to Grand View Research, in ****, North America dominated the market with a global revenue share ...

1.3 An Italian market struggling to meet growing demand

The private nursing home sector in Italy is highly fragmented and includes many small and medium-sized companies, as well as a few large national and international players, shown in section *.* of the segmentation. This means that the returns of individual facilities can vary widely depending on their location, the characteristics of their clientele, and the management and marketing capabilities of individual companies. These players are trying to gain higher market share by adopting strategies, such as investments, partnerships, acquisitions, and mergers. However, it is a phenomenon that is mainly affecting other countries. In ****, for example, Omega Healthcare entered into a $*** million deal with Healthpeak Properties and acquired Brookdale Senior Living in the United States.

Hospitals and nursing homes turnover Italy, ****-****, in billions of euros Source: ****

On the one hand, the nursing home market has been fluctuating but rather stable. In **** it reached its peak by recording a turnover more than ** million euros. However, it came to a standstill in ****. The causes of the halt would be traced to the outbreak of the COVID pandemic and the restrictions imposed.

On the other hand, the value of production in Italy grew steadily from **** until ****. The value of production, according to ISTAT (***), represents ...

1.4 Consequences of COVID-19 and the war in Ukraine

Assisted living facilities, including nursing homes, have been one of the sectors most affected by the COVID pandemic. The causes can be traced to the presence of the elderly who are considered a highly vulnerable group. A meta-analysis found that the age-specific infection mortality rate is very low for children and young adults, but gradually increases to *.* percent at age **, *.* percent at age **, *.* percent at age **, and ** percent at age **.

Since the beginning of the pandemic outbreak, health care residences have been negatively impacted by experiencing financial instabilities and sometimes closures of residences.

A study published in January **** found that Lombardy, Sardinia Abruzzo-Molise were the regions with the highest mortality rates per *** residents of assisted living residences. Higher mortality can be observed for almost all but four regions-Lazio, Umbria, Calabria and Puglia.

However, in the last phase of the epidemic spread, nursing homes and long-term care services have begun to resume with appropriate COVID-** guidelines. In particular, the adoption of digital technologies (***) has supported market growth.

the market consequences of the war in Ukraine

The situation in Ukraine is affecting the global economy and indirectly impacting the incomes of Italian households. In particular, as energy, gas and other fuel prices rise ...

2.1 Determinants of demand

The main driver of demand is the growing aging of the Italian population, which has a steady increasing trend in countries of the Western world in recent decades. In ****, Italy was ranked as the oldest country in Europe with:

**.* percent of the total population being ** years of age or older. The Higher Institute of Health (***) predicts that by ****, the proportion of the elderly population will reach **.* percent of the total Italian population. Contributing to the growth will be Baby baby-boomers born in the ****s and before the mid-****s. A life expectancy among the highest in the world, that is, an average of ** years for men and ** for women.

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

the choice between a private and an accredited nursing home may depend on the needs and economic possibilities of the patient or his or her family.

At the income level, Italian families have an average income between ** and ** thousand euros, depending on the number of members. The income one is an important aspect, given the high costs of private health care. Despite this, families decide to allocate part of their resources to private healthcare also driven by ...

2.2 Characteristics of growing demand

The demand for nursing homes in Italy is expected to grow in the near future due to increased life expectancy and greater awareness of the importance of health care and treatment.

It is not possible to provide a precise typology of those admitted to nursing homes in Italy and their preferences, as they are people with different characteristics and needs. However, there are some general trends that emerge from research on the subject. In general, nursing home inpatients in Italy are elderly people with chronic conditions or disabilities that require ongoing care and daily assistance. Inpatients' preferences depend on their needs and the type of facility desired. In general, older people living in nursing homes want to be treated with respect and dignity, to have personal care and adequate medical care, to have opportunities to socialize and participate in recreational and cultural activities, and to feel safe and secure. Many older people also prefer to remain close to their family and friends and have the opportunity to maintain contact with them. However, individual preferences may vary depending on life experiences, health, and other personal factors.

Examining the most up-to-date data available as of **** released by the Ministry of Health shows that ...

3.1 Differentiation of nursing homes

Nursing homes are assisted-living residences that can be operated by private individuals or legal entities, which provide for the hospitalization of Italian or foreign citizens for diagnostic, curative or rehabilitative purposes.

Nursing homes are distinguished into:

General medical and surgical nursing homes, which admit patients with morbid forms pertaining to general medicine, general surgery and medical and surgical specialties. Medical nursing homes , which admit patients of morbid forms pertaining to general medicine and medical specialties. Surgical nursing homes, which admit patients of morbid forms pertaining to general surgery and surgical specialties. Multi-specialty nursing homes, which admit patients of morbid forms pertaining to two or more specialties falling within the scope of general medicine or general surgery. Single-specialty nursing homes, which admit patients of morbid forms pertaining to only one specialty, medical or surgical. Specialty-oriented nursing homes (***).

In addition, According to Italian regulations, the minimum accommodation capacity of private nursing homes has been set as follows:

*** bed places for general medical-surgical nursing homes. ** bed places for all other nursing homes.

Nursinghomes can be accreditedand thus have an agreement entered into with the National Health System (***).

The regions with the lowest number of nursing homes are Molise, Basilicata and Valle d'Aosta. However, ...

3.2 A fragmented market

The assisted living residences market in Italy consists of two main segments: the public sector and the private sector.

The public sector is represented by health and social care facilities managed directly by the National Health Service, which offer health and social care services to citizens based on patients' needs and pathologies. Public sector facilities are financed by the state and local governments, and offer services at low prices or completely free of charge.

The private sector is the main one for nursing homes, which are run by private sector companies and operators. These facilities offer health and social care services on a fee-for-service basis, often of high quality and with greater personalization of care than public sector facilities.

The nursing home market in Italy is highly fragmented, with many small and medium-sized companies operating facilities of various sizes and specializations. However, recent years have been witnessing an increasing concentration of the market, with the emergence of large corporate groups operating multiple facilities in different regions of the country (***).

Analyzing The total number of active hospital and nursing facilities with Italian ateco code ****, in the period ****-****, it can be seen that the number has not changed much, reaching **** in ****. In ...

3.3 Distribution channels

In Italy, nursing homes use different distribution channels to reach their patients and provide their services. Some of the common distribution channels for nursing homes in Italy include:

GP referrals: many nursing homes receive patients through referrals from GPs or other hospitals. Direct between nursing homes and patients: nursing homes may advertise their services and accept patients directly through their website, advertisements, social media and other forms of direct marketing. Agreements with insurance companies: many nursing homes in Italy have agreements with insurance companies to provide health care services to their clients. Through public health facilities: some nursing homes partner with public health facilities, such as hospitals or clinics, to provide health services to their patients. Network of distributors and affiliates: some large nursing home chains in Italy use a network of distributors and affiliates to reach a wider audience and provide health care services in multiple locations.

In general, nursing homes in Italy use a combination of these distribution channels to reach their target audiences and provide their health care services.

4.1 Analysis of supply struggling to meet demand

the accessibility and quality of services offered can vary considerably. In addition, the public supply of nursing homes is often insufficient in relation to demand, which could lead to the need for more investment and public policies aimed at improving the care offered to people in need of treatment.

The most recent data published in the Ministry of Health Yearbook, show the different types of medical treatments and the number of different services present and offered for each type by nursing homes in Italy. Diagnostic imaging has the highest number of services offered, namely ***, among all nursing homes in Italy in ****. With diagnostic imaging or biomedical imaging, it is possible to observe an area of an organism that is not visible from the outside. For example, radiology is the most widely used branch of medicine in this service. Resuscitation, with **, is the branch of medicine that deals with the critically ill patient and the care and restoration of impaired vital functions. Dialysis, with **, is a medical treatment that replaces some of the functions of the kidneys in patients with acute or chronic kidney failure.

Number of services in accredited nursing homes Italy, ****, in absolute value Source: ****

Supply-side trends in the ...

4.2 The rates of nursing homes

In Italy, they can vary significantly by region, city, facility, type of service required and length of stay. In addition, nursing homes are almost private. Thus, monthly fees vary depending on whether the facilities are accredited or not, that is, whether it has entered into an agreement with the National Health System or not. The Italian health care system is a universal public health care system that offers free or low-cost health care to all Italian citizens and legal residents in the country. The health care system is financed through taxes and social contributions and managed mainly by the National Health Service (***).

From the chart below, Italy ranks fifth in terms of share of cost (***) covered by public authority or insurance. It should be mentioned that the number of accredited nursing homes, amounting to *** facilities, clearly outnumbers the number of unaccredited ones, amounting to ** facilities. Also,

Share of daily cost in nursing homes covered by public authorities or insurance Europe, Italy, ****, in Percentage Source: ****

In general, private nursing homes offer high-quality services, but the cost can be very high. In Italy and Europe, in ****, the highest average cost, recorded by Orpea Group, was *** euros per day in Luxembourg, while Italy had ...

5.1 Technical requirements on private nursing homes

Ministerial Decree No. *** of August *, ****, approved ** articles relating to the determination of technical requirements on nursing homes.

Art. *, Chapter I, refers to the previously given definition of private nursing homes. Private nursing homes are those health establishments operated by private individuals or legal entities, which provide for the hospitalization of Italian or foreign citizens for diagnostic, curative or rehabilitative purposes.

Art. * is important in that it regulates the authorization to open and states that Authorization for the opening of private nursing homes and the expansion or transformation thereof shall be granted by the competent regional bodies, pursuant to Art. * of Presidential Decree No. * of January **, ****, in accordance with the procedures set forth in Art. ** of Law No. *** of February **, ****, and in compliance with the rules established by this decree.

In Chapter III, Art. ** states the general requirements for each private nursing home. It states that in addition to meeting the requirements of hospital hygiene and technology, there must be at least the following rooms and services:

admission service; inpatient rooms distinguished according to the nature of the services, sex and age of the patients; living and waiting rooms; rooms and services for temporary isolation of patients with diffusive forms; radiodiagnostic service; analytical ...

6.1 Segmentation

belgium and Spain.

• Ospedale San Raffaele
• Humanitas Mirasole S.p.A.
• KOS SPA
• Sereni Orizzonti
• Codess Sociale
• Universiis