A hospital stay in Lombardy costs half as much as in Sicily, the paradox of Italy split in two

The budgets speak clearly and reveal a deeply divided Italy even - and especially - in the healthcare sector, with an extremely high emigration rate to other regions and million-dollar costs for public finances. But there is also a figure - that of hospitalization costs - that takes on paradoxical contours depending on the latitude. It emerges from the numbers provided by Agenas for 2023 and highlights the abyssal gap between healthcare facilities in the South and those in the North: a day of hospitalization in the hospitals of the Island can cost the State more than double the daily cost of a stay in Lombardy.

Looking at the Sicilian data, the costs absorb enormous resources, comparable to those of actual five-star hotel stays. The Giaccone University Hospital in Palermo, for example, presents a bill of 889 euros per day for each individual patient hospitalized. Moving towards the eastern coast of Sicily, the situation mirrors the same dynamics: the Martino Hospital in Messina records a daily cost for the State of 716 euros. But the Sicilian peak is reached by analyzing the pure hospital companies, those not linked to universities and research: the Papardo Hospital in Messina even breaks the thousand-euro barrier, standing at 1,031.6 euros for each single day of hospitalization. Even the Garibaldi Hospital in Catania remains well above the national average with its 703 euros per day.

What happens, however, if a citizen is hospitalized in the deep North? The figures drop dramatically. Considering the San Matteo Hospital-University Company in Pavia, the bill stops at just 400 euros for each day of hospitalization. The numerical comparison is merciless and leaves no room for interpretation: a patient treated at the Papardo in Messina costs the State over 150% more than one treated in Pavia, while the Giaccone in Palermo costs more than double that of San Matteo. The Agenas data is also calculated according to the "average cost per day of acute hospitalization weighted for complexity." This means that the calculation already takes into account the severity of the treated condition (such as heart attacks, pneumonia, or strokes) and the necessary resource absorption. With the same diagnosis and medical urgency, therefore, the economic gap remains intact and complexity is not a valid excuse.

What are the reasons for such a gap in public accounts? One hypothesis is the impact of fixed costs in the South, where large but old structures weigh heavily, a lower utilization of spaces, and the presence of non-standard machinery. Yet, even if we were to admit the existence of serious structural inefficiencies, this would not be enough to justify rates that reach triple or double the costs of their northern counterparts. Price lists that seem to belong to different countries: either southern companies waste enormous resources, or those in the North, while maintaining extremely high standards, manage to do so by tightening their belts to an incredible degree.