Poverty and private health expenditures in Italian households during the recent crisis.

The global financial crisis that began in 2008 had an overall effect on the health behaviours of Italian households. Aggregate private health expenditures have decreased while the citizens have increasingly been asked to share health costs. The reduction of households' health expenditure could have serious consequences for health, especially if it concerns the most vulnerable people. The aim of this paper is to analyse the relation between poverty and household health expenditure, considering regional and social group variations. The data used stem from the "Family Expenditure Survey" collected by the Italian Statistical Institute (ISTAT) from 1997 to 2013. Results of multivariate analysis controlling for potential socio-demographic confounders show that the propensity to spend for poor families is decreased in the last years compared to not poor households. Meanwhile, among the households who spend, the average expenditure in euro seems to have been more stable over time. This is an alarming signal for the health of the most vulnerable households. These conditions could result in a gradual deterioration of health in poor families, which is likely to increase the burden on health systems in future. Hence, at this moment public intervention does not seem able to alleviate this situation.

New Scope for Research in Traditional and Non-conventional Medicine Comment on "Substitutes or Complements? Diagnosis and Treatment with Non-conventional and Conventional Medicine".

The article takes its cue from models of quantitative research applied to complementary/alternative medicine (CAM) and pinpoints some innovative features in the case at issue (Portugal). It goes on to outline new research scenarios moving beyond the either biomedical or CAM framework.

Social inequalities and pharmaceutical cost sharing in Italian regions.

In recent years, Italian citizens have increasingly been asked to share pharmaceutical costs, but at the same time, households' medicines expenditure has decreased. Cost-sharing policies have to be assessed not just in terms of limitation of moral hazard and revenue to the state, but also for equal opportunities for citizen users accessing health services. The aim of this article is to analyze how Italian co-payment policies ("ticket") on medicines may affect pharmaceutical expenditure of households, considering territorial and social groups variation. We reviewed the per capita private spending on medicines of Italian regions, separating pharmaceutical outlay and "ticket." Across the period 2001-2010 we found that the overall per capita private spending on medicines remained substantially stable, although medicine expenditure decreases while the "ticket" increases. When cost sharing rises, out-of-pocket spending on medicines by poorer families seems to remain unchanged; however, poorer families seem to reduce their pharmaceutical expenditure. Our analysis suggests that applying co-payment in Italy is partly successful, in terms of greater revenue to the health system, but in the last few years, cost-sharing increases would seem to have rebounded negatively on more vulnerable families, due to the economic crisis.

The need for higher education in the sociology of traditional and non-conventional medicine in Italy: towards a person-centered medicine.

Italy is being forced to re-think her health plan as the national health service moves towards regional systems, individuals take more active responsibility for their health, the demand grows for traditional and non-conventional medicine and immigrants join the user list. Person-centered medicine and ever-wider skills attainable with the tools of analysis and research have made a new professional update indispensable. The proposed Master-Course on "Health systems, traditional and non-conventional medicine", first of its kind in Italy, fits this bill. The new forms of treatment that state and international bodies are prepared to recognize depend entirely on the universities training our professionals with concrete skills in planning, research and health management. Our paper performs an epistemological critique of the new health requirements and goes on to outline the reasons behind this training imperative.

Regional Health Systems and non-conventional medicine: the situation in Italy.

In Italy the different regional healthcare models are structured, in order to provide both a single theoretical framework and to enable direct comparisons. In this paper we examine whether and how the regional healthcare systems include alternative medicines and, if so, whether this can be specifically attributed to the different organisational models in place. This analysis will be preceded by a framework to show how in Italy there is a constant and continuous increase in non-conventional medicine (NCM), determined from a research by citizens of a person-centred medicine and preventive. We shall examine how NCM has been incorporated in the National Health System (SSN) in Italy, from the time the Regional Health Systems were set up, and the factors that have contributed to their inclusion or exclusion. After a brief synopsis of the process of growth, distribution and recognition of NCM in Italy, we shall describe how it has been incorporated and consolidated in the regional healthcare systems.