Financing and managing health expenditure: evaluation of aging and capitation criteria in the Italian healthcare system

The object of this work is to isolate and to evaluate the role played by aging in the annual cost variation. The aim is to strength the congruence between central health policy concern and the understanding of the annual cost variation at Local Health Unit level. The sample regards pharmaceutical, hospital and outpatient cost in the ASL of Lecco: a Lombardy’s Local Health Unit which covers about three hundred thousand citizens. The period analysed is 2001-2004. We found that in our case study the impact, ceteris paribus, of the aging on the total expenditure growth has been relative according to recent literature findings. Further, the study does not show any evidence suggesting different growth rate between elderly and the rest of the population, supporting the thesis that short and medium term dynamics are driven mainly by other patterns. Indeed, the role of the product innovation, analysed in regard of the pharmaceutical expense, has been found to have an annual impact three times greater than the aging effect.