Long-term care: Patients are generally treated in residential (approximately 213,000 beds in 2010) or semi-residential (approximately 48,000 beds) facilities, or in community home care (approximately 600,000 cases). Residential and semi-residential services provide nurse, physician, and specialist care; rehabilitation services; and medical therapies and devices. Patients must be referred in order to receive residential care. Cost-sharing for residential services varies widely according to region, but is generally determined by patient income. Community home care is funded publicly, whereas residential facilities are managed by a mixture of public and private, for-profit and nonprofit organizations. Unlike residential and semi-residential care, community home care is not designed to provide physical or mental care services but rather to enhance a patient’s autonomy by providing additional assistance throughout a course of treatment or therapy. In spite of government provision of residential and home care services, long-term care in Italy has traditionally been characterized by a low degree of public financing and provision ass compared with other European countries.
Until 1999, palliative care was very limited and was concentrated mainly in northern Italy. Much was left to the efforts of voluntary organizations, which still play a crucial role in the delivery of these services. Although much still needs to be done to ensure the diffusion of homogeneous palliative care services, a national policy on palliative care has been in place since the end of the 1990s and has contributed to an increase in palliative care services such as hospices, day-care centers, and palliative care units within hospitals.