The private clinic market - Italy (2024)

1.2 The global market

Private hospitals can have two distinct purposes : for-profit and nonprofit. As can be seen from the chart, the number of for-profit hospitals per country is, on average, significantly higher than the number of nonprofit hospitals. Globally, it is Colombia that has the largest number of private hospitals, some ****, with a total of *** clinics per * million inhabitants. The United States follows, with a total of **** of which, however, ** percent are private nonprofit hospitals. Mexico, on the other hand, has the highest percentage of private for-profit hospitals, **.* percent of the total having this form. South Korea, on the other hand, has exclusively private nonprofit hospitals,about ****.

Overall, the global private hospital market was worth about $*** billion in **** and is estimated to grow to about $* trillion by ****, with a compound annual growth rate (***) of about **.* percent over the forecast period.[***]

Total Number of Private, Nonprofit and For-profit Hospitals World, ****, number of hospitals Source: ****

1.2 The Italian Market

Private healthcare in Italy is worth about **.* billion euros a year, accounting for nearly ** percent of total national healthcare spending. The top ** private hospital groups put together a turnover of as much as *.* billion euros, annually.

As of ****, there were a total of about *** private for-profit hospitals, a figure that is up sharply from **** but down slightly , -*%, from **** figures.

Evolution Number of Private Hospitals in Italy Italy, **** - ****, in number of hospitals Source: ****

if all other types of nursing homes, and not just hospitals, were taken into account, there were a total of *,*** nursing homes in Italy , **.*% of which were public and the remaining **.*% accredited private.[***] In total, the facilities surveyed amounted to: *. *** foroutpatient specialist care, *,*** forresidential territorial care, *,*** forsemiresidential territorial care, *,*** forother territorial care and *,*** for rehabilitation care (***).

Number of facilities by type of care provided Italy, ****, in percent Source: ****

1.4 The Covid Effect 19

During the crisis, public-private cooperation was essential to meet the need for care. Public and private institutions pooled available beds: the most serious cases were mainly taken over by institutions with intensive care units, and private clinics, which are usually responsible for follow-up care or planned acts, took over the less serious cases, or patients "at the end of life."

Out of a total of **** hospital wards in Italy available in accredited private facilities, as many as *** were devoted exclusively to Covid-** care. Same for ordinary inpatient beds, out of a total of ***** available beds, **.*% were turned into Covid beds. The region with the highest number of beds converted to private facilities, out of the total number of available beds, was Valle d'Aosta with **.*% of the converted beds, followed by Lombardy, with **.*% of the converted beds, Emilia Romagna with **.**% and Campania with **.*%

2.1 The Main Drivers of Demand

Several drivers can drive the demand for private clinics in Italy. We can find two main categories, demographic characteristics of the Italian population and income characteristics .

The age distribution andmedian age of the Italian population are also important factors to consider in order to better understand this market and its customers.

The Italian population is composed of about ** million people, distributed in ** regions (***), under the significant effect of declining birth rates and increasing life expectancy, which has led to an increase in the percentage life expectancy of people aged ** or older to **.* percent.

Italian population distribution Italy, ****-****, as a percentage of population Source: ****

At the income level, Italian households 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, more and more people are deciding to allocate part of their resources to private healthcare. In ****, **% of total spending on healthcare went to private facilities, a figure that for the first time decreased from the previous year due to the blocks imposed by Covid. (***). In total, in ****, spending on healthcare accounted for *.* percent of total Italian household consumer spending.

Evolution ...

2.2 Italians' opinion of the national health care system

Analyzing the Italian population's satisfaction with the services offered during hospitalization in ****, **.*% of respondents say they are fairly or very satisfied with the medical care they received; **.*% say the same for nursing care while **.*% are generally satisfied with the toilet facilities. However, the food service offered during hospitalization appears to be appreciated by just over * out of * Italians during hospitalization (***).

Satisfaction with various aspects of hospitalization (***) Italy, ****, % Istat

Between **** and **** there is evidence of substantial stability in the degree of satisfaction among Italians with the medical care received during hospitalization. As shown in the graph below, during the period analyzed, satisfaction levels fluctuated between **.* percent recorded during **** and **.* percent recorded in ****. Satisfaction with medical care during hospitalization (***) Italy, ****-****, % Istat Several factors account for this dissatisfaction, led by long waiting lists creating the most inconvenience (***) experienced medical errors.

Reasons for dissatisfaction with the NHS Italy, ****, in percent Source: ****

2.3 Patients

There are about * million hospitalizations in Italy each year. According to the latest available data, dating back to ****, a general decrease in the volume of activity provided by Italian hospitals can be observed: the total number of discharges for acute, rehabilitation and long-term care went from *.***.*** to *,***,***, a decrease of about *.* percent compared to ****; the corresponding total volume of days went from **,***,*** to **,***,***, a decrease of about *.* percent.

The largest reduction in discharges is observed in acute care activity in the ordinary setting (***).

Compared with ****, in **** the acute care hospitalization rate, standardized by age and sex in Italy, decreased from ***.* to ***.* discharges per *,*** population, divided into **.* discharges (***). A fair amount of regional variability is also observed.[***]

Moreover, when European data are taken into consideration, contrary to expectations, it would appear that the use of private care does not vary by socio-professional category: ** percent of managers and professionals, ** percent of blue-collar workers and ** percent of employees have already used private care. Similarly, ** percent of private employees and ** percent of public employees have used private care.

As for the services provided by hospitals, we can see that those most provided are those related to physical rehabilitation, **.* million, of which *.* million were provided in ...

3.1 Market structure

The hospital sector in Italy is divided into public facilities, private for-profit facilities and private nonprofit facilities. In total, there are **** clinics in Italy. different types of clinics can be distinguished :

The following are defined as public inpatient facilities

Hospital corporations; Directly operated hospitals; Hospital corporations integrated with the National Health Service; Hospital corporations integrated with the University; public IRCCSs also established as foundations.

Inpatient facilities equated with public ones are defined as:

private university polyclinics; private IRCCSs and private foundations; Hospitals classified or assimilated under Article *, last paragraph, L. ***/****; Private institutions qualified A.S.L. garrisons; Research institutions.

Private inpatient facilities , on the other hand, are defined as licensed private nursing homes , accredited and not with the SSN.

An indicator of the relevance of the accredited private sector in healthcare is the weight within overall SSN spending. In ****, the latest available data, SSN spending on accredited private care averaged € *** per inhabitant, accounting for **.* percent of overall SSN spending, up from **** (***) is made up of spending on hospitalization in accredited facilities, while another **.* percent can be attributed to "Other accredited care," which is mainly related to territorial social-health care in residential facilities.

beds

**.* percent of total beds

**.* percent

accredited ...

3.2 The geographical distribution of private clinics

In order to highlight the geographical distribution of the supply of private clinics, a map was created with the number of clinics in each Italian region.

In the South of the peninsula, thanks to the values recorded in Campania, **.*% of the total number of private clinics in Italy is concentrated. This is followed by the Northwest and the Center, where, on the other hand, **.*% and **.*% of the total number of clinics is present, respectively. In the Northeast, there are ** private clinics, accounting for **.* percent of the total while in the Islands the total drops to **, accounting for **.* percent of the national total.

3.3 The Staff of Private Clinics

Research by the Eurostat agency in August **** shows that our country has the second most physicians on an EU scale. Private healthcare facilities, in aggregate, incur about *.* billion euros as personnel costs. As for capital assets, the value is more than *.* billion euros for tangible assets, while it is *** million euros for intangible assets.[***]

In total, there are ***,*** registered physicians in Italy. Of these, **,*** specialize in cardiology, **,*** in neurology and **,*** in internal medicine .

In terms of the professions they practice, ***,*** are hospital physicians, ***,*** are specialists in private practice, and**,*** are general practitioners. **.in contrast, *** are physicians in nursing homes.

Regionally, most physicians are in Lombardy, with more than **,*** professionals. This is followed by Latium and Campania.

Regarding the breakdown by age group, significant is knowing that ** percent of general practitioners will retire in the next * years.

If we take into consideration the data of the Aiop association, which has *** member facilities, for about ** thousand beds, of which ** thousand are accredited, at the national level, the number of staff in private facilities is more than ** thousand: ** thousand are physicians, ** thousand are nurses and technicians, and ** thousand are support workers. Sixty-nine percent of all employees are female, and ** percent are employed on permanent ...

3.4 The main actors

A list of major players active in private clinic services is offered below:

San Donato Group: founded in **** in Pavia by Luigi Rotelli, is one of the largest private hospital groups in Italy. Headquartered in Milan, the group has developed considerably since **** under the leadership of Giuseppe Rotelli, son of the founder. Today, the San Donato Group includes a diagnostic center and nineteen hospitals, three of which are Scientific Hospitalization and Treatment Institutes (***), located mainly in Lombardy and two in Emilia-Romagna in Bologna. The group is distinguished by its commitment to scientific research and university education, collaborating with several Italian universities.

Humanitas Mirasole s.p.a: founded in ****,is a renowned hospital in Italy, known for its high specialization, research and university teaching. This institute is distinguished for its advanced technology and for being a world reference center in research on diseases related to the immune system, including oncological diseases and cardiovascular, neurological and orthopedic diseases. Among its most modern equipment, Humanitas has linear accelerators for radiotherapy, surgical robots for less invasive surgeries, and advanced systems in ophthalmology and radiology. Humanitas is not only committed to providing quality medical services, but is also a recognized center for organizational efficiency and clinical ...

4.1 A Quality and Innovative Offering

Quality of accommodation

The clinics were the first to offer single rooms and to pay special attention to the quality of hotel and dining facilities, but also to the presence of ancillary services such as a nursery, restaurant, or conference center. [***]

Research and technological innovation

The rapid evolution of technology is revolutionizing medicine and our health care system. Medical innovation is a major challenge for private hospitalization because it promotes the emergence of new therapeutic and diagnostic strategies for patients.

Clinics are participating in research these techniques have led to the development of new minimally invasive surgical techniques, such as laparoscopy (***), digestive and biliopancreatic endoscopy, and diagnosis by videoendoscopy. They also equip themselves with equipment (***) and invest in surgical robots From an organizational perspective, they support the development of society by offering innovative support methods such as telemedicine or the use of connected health applications.

The Digitization of Hospital Processes

Private clinics are in line with the digitization trend in healthcare and meet the expectations of a large majority of Italians in favor of hospital digitization and the implementation of digital services by hospitals and clinics. This process saves time for patients and speeds up hospital control processes.

Private clinics are ...

4.2 The Prices of Private Health Care Facilities

The prices of various health treatments and services offered by private clinics varies greatly by region and City. Milan turns out to be the most expensive city for private health care and where there are the greatest price differences between private facilities (***), Palermo, on the other hand, turns out to be the least expensive, where prices are -***% lower than in Milan . in Turin , on the other hand, there are large price differences between private facilities offering the same services, as in the case of the cost of a gastroscopy for which there are price differences of ***%.

Waiting lists, heavily criticized for public health care, also vary by city. In Milan, for an MRI, one can wait as long as two weeks .

The chart shows the ranking of the ** most expensive cities in Italy when it comes to private health care. Specifically, the graph shows how much more expensive the city is compared to Palermo, a cheaper city.

The most expensive cities for private health care, in percentage difference from Turin Italy, ****, in percent Source: ****

The following table shows the price in these cities of various hospital and non-hospital services.

5.1 Accreditation of Private Facilities within the NHS

the path that private health care facilities must take to be accredited within the SSN is called the three A's system (***) and involves three steps that allow them to be equalized with public ones.

Authorization

The first step is authorization. The purpose of authorization is to allow the exercise of health activity, and any entity (***) operating within the SSN must be authorized under Legislative Decree ***/**. Authorization must be requested from the region where one intends to start the activity, for all facilities, both public and private, that provide inpatient services, that provide outpatient services, that provide residential services, and for dental/medical/other health professions practices, including nursing practices.

As for the requirements for authorization, the choice is left to the individual region, which sanctions the criteria for inclusion, and must include minimum structural, technological and organizational requirements. Ultimately, the issuance of authorization by the Region is also influenced by the verification activities of the municipality within which the facility will reside.

Accreditation

Step following authorization is accreditation with the SSN, this step is compulsory only for those facilities that want to operate in agreement with public health care, if you want to provide services under private arrangements the path stops ...

6.1 Segmentation

• Gruppo San Donato
• Humanitas Mirasole S.p.A.
• Gruppo Villa Maria s.p.a
• Kos s.p.a
• Garofalo Health Care s.p.a