After the difficult period caused by the pandemic, Italy recorded an increase in hospital admissions in 2023, reaching almost 8 million, with an increase of 312 thousand compared to the previous year. These data are close to those pre-pandemic. However, the quality of healthcare services varies significantly between facilities: many hospitals have high-quality areas alongside areas with lower standards. In particular, oncology interventions are often performed in hospitals with insufficient volumes to ensure the best technologies and practices, especially for pancreatic cancer. There are also concerns in the maternal and child sector, as a third of birth centers do not reach 500 births per year, considered a safety benchmark.

The National Outcomes Program analyzed the performance of over 1,300 hospitals, using 205 indicators. A significant aspect is represented by interventions for femur fractures, where the number of operations performed within 48 hours has increased: in 2023, 95,808 interventions were recorded, with a 59% increase in those performed promptly. However, most hospitals still do not exceed the 60% threshold in terms of timeliness, with critical situations in some regions such as Calabria and Liguria.

Regarding laparoscopic cholecystectomies, approximately 101,700 interventions were performed in 2023, with an improvement in post-operative hospitalization: 88% of patients were discharged within three days of the intervention. Although a certain homogeneity in performance is observed between the facilities, there is still room for improvement.

In the maternity sector, births in Italy were 381,766 in 2023, marking a decrease compared to the previous year, and the number of facilities that perform fewer than 500 births per year continues to increase. The cesarean section rate decreased slightly to 22.7%, but in the southern territories the levels are still higher than the rest of the country.

The data also highlight significant challenges in cancer. Patients with breast and pancreatic cancer are often operated on in hospitals with low activity volumes. For example, for pancreatic cancer there are only ten facilities that perform at least 50 operations per year. For other types of cancer such as colon and prostate, although there are improvements in the concentration of cases in high-activity facilities, there remains significant variability between different Italian regions.