C.R.E.A. Healthcare

Healthcare performance: Veneto, Trento and Tuscany top the rankings

Regions are recovering, but North-South regional inequalities persist, whilst citizens are calling for more services to address the loss of self-sufficiency

by Health Editorial Team

1 July 2026

OSPEDALE INFERMIERI DOTTORI DOTTORE INERMIERE IMAGOECONOMICA

3' min read

Translated by AI

Versione italiana

3' min read

Translated by AI

Versione italiana

There has been a significant renewed focus on the economic and financial dimension in the assessment of regional healthcare systems’ performance. Accounting for 12.7 per cent of overall performance, this aspect ranks third, behind outcomes (31.2 per cent) and appropriateness (27.5 per cent), marking an increase compared with the previous edition (+1.6 percentage points). This is highlighted in the 14th Report on the Regional Performance of the Italian Healthcare System, compiled by C.R.E.A. Sanità (Centre for Applied Economic Research in Healthcare), presented today in Rome.

Overall, the Report points to a general improvement between 2019 and 2025, with the average national performance index rising from 43.4% to 46.1%. However, significant regional disparities remain: Veneto remains the best-performing region at 64% of the theoretical maximum, followed by the Autonomous Province of Trento (62%), whilst Calabria comes last at 36%.

This year’s Report introduces an assessment of citizens’ perception of improvement, in addition to their current level of satisfaction. A positive correlation has emerged: those who perceive improvements in services report being more satisfied, regardless of the level of performance. However, only 18 per cent of the population has noticed progress over the medium term, with significant differences between regions.

Economy: regional results

Veneto remains at the top of the overall ranking with an economic and financial performance index of 64 per cent, followed by the Autonomous Province of Trento (62 per cent) and Tuscany (61 per cent). These regions demonstrate efficient resource management, with per capita public healthcare expenditure approaching the European average and standardised total per capita healthcare expenditure reflecting a good balance between costs and the quality of services.

By contrast, the southern regions, such as Calabria (36 per cent), Sicily (35 per cent) and Molise (31 per cent), continue to record the lowest levels, highlighting structural difficulties in the economic management of the healthcare system. However, an improvement in economic and financial performance can be observed in some of these areas, such as Calabria, which recorded a significant increase (+0.065 percentage points) over the period 2019–2025.

Stakeholder feedback

Stakeholders in the healthcare system have expressed differing views on the economic and financial aspects. Company management attaches significant importance to this aspect (20.2 per cent), highlighting the need for economic efficiency to ensure the sustainability of the National Health Service. Institutions also recognise the importance of economic management, which accounts for 12.2 per cent of overall performance.

Whilst the healthcare professions focus primarily on outcomes and appropriateness, they attribute a weighting of 12.2% to the economic and financial dimension, indicating a growing awareness of the impact of economic resources on the quality of care. Users, on the other hand, pay less attention to this aspect, with a contribution of 6.5 per cent, prioritising factors linked to outcomes and quality of life.

Public perception

Despite the improvement in economic and financial performance, the public’s perception of progress in this area remains limited. The proportion of the population that has perceived an improvement in healthcare services over the medium term varies significantly between regions, with figures ranging from 8.6% in Trentino-Alto Adige to 25.9% in Abruzzo and Molise.

In particular, access to medicines is the area that has recorded the highest levels of satisfaction, with 30% of citizens perceiving an improvement at national level. However, local care services and support for those who are not self-sufficient continue to be critical areas, with perceived improvement rates of less than 20%.

The 14th C.R.E.A. Sanità Report highlights that, although economic and financial factors have regained prominence in the assessment of regional performance, significant regional inequalities persist and the public’s perception of improvements remains limited. “These findings,” explains the Centre for Economics and Research, “highlight the need for an ongoing commitment to ensuring the efficient management of resources, improving the quality of services and reducing regional inequalities, with particular attention to local services and long-term care.”

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