1. An Assessment of Effects of Socioeconomic Status, Employment Type, and Employee Benefits on Italian Healthcare Access and Delivery in Milan

2. Survey

3. Italian Translation

4. Survey Sample

9. Research Results

10. Quality of Care

13. Access to Care

16.  Wait Period for Physician Appointment:  Average: 11.94 days  Max: 90 days  Min: 0 days  Wait Period in Physician’s Clinic:  Average: 2.52 hours  Max: 12 hours  Min: 30 minutes Access to Care

17. Cost of Care

19. Opinions on Insurance Systems

21. Major Observations: In Conjunction with Income Levels

22.  A greater number of individuals with monthly incomes lower than €2000 thought that public health insurance did not provide a broad range of services than did individuals with monthly incomes higher than €2000 (29.17% vs. 15.56%) Quality of Care

23.  A greater number of individuals with monthly incomes lower than €2000 faced challenges in seeking primary physician care than did individuals with monthly incomes higher than €2000 (13.33% vs. 8.89%)  A greater number of individuals with monthly incomes lower than €2000 faced challenges in seeking specialist care than did individuals with monthly incomes higher than €2000 (21.67% vs. 8.89%)  A greater number of individuals with monthly incomes lower than €2000 faced challenges in seeking diagnostic tests than did individuals with monthly incomes higher than €2000 (25% vs. 10%) Access to Care

24.  Individuals with monthly incomes lower than €2000 spent SIGNIFICANTLY more time on an average waiting for a physician’s appointment than did individuals with monthly incomes higher than €2000 (10.9 days vs. 1.43 days)  Individuals with monthly incomes lower than €2000 spent SIGNIFICANTLY more time on an average waiting their appointment at the doctor’s clinic than did individuals with monthly incomes higher than €2000 (2.23 vs 0.44 hours or 134 vs. 27 minutes) Access to Care

25.  A greater number of individuals with monthly incomes lower than €2000 made out of pocket contributions to healthcare than did individuals with monthly incomes higher than €2000 (45.85% vs. 13.33%)  These out of pocket contributions were more likely to represent a significant portion of the take-home income for individuals with monthly incomes lower than €2000 than for individuals with monthly incomes higher than €2000 (16.67% vs. 0%) Cost of Care

26.  A greater number of individuals with monthly incomes lower than €2000 were satisfied with the public health insurance system than were individuals with monthly incomes higher than €2000 (50% vs. 24.44%)  A greater number of individuals with monthly incomes lower than €2000 were open to purchasing private insurance if it translated to more coverage options and more efficient care than were individuals with monthly incomes higher than €2000 (26.67% vs. 17.78%) Opinions on Health Insurance Systems

27.  “We don’t have insurance here.”  “I would be willing to buy [private] health insurance only if I wouldn't deposit [more] money to the state, as the taxes that I pay are much more than enough. Unfortunately, [not purchasing one] affects our [healthcare options].”  “[Our system] doesn't [allow you to see the same] professional doctor for specialist care. [Therefore, there is] discomfort with the continuity of care.” Additional Comments

28.  Regional Disparity  High quality service within public healthcare framework in the North  Not the same story in the South, hence push for private coverage  Non-emergency care wait times long across the nation  Example: cataract surgery wait times around 9-12 months Interview w/ Dr. Stefano Rusconi

29. Some Pictures