Regional healthcare finances under strain: deficit exceeds €2.5bn in 2024

The national monitoring picture
Italy’s National Health Service (SSN) accounts have slipped back into marked distress. According to figures from the Adempimenti Verification Table, analysed in the spending-monitoring report by the Ragioneria generale dello Stato, 2024 closes with an overall deficit of €2.57 billion, the worst result recorded over the past decade.

A steady deterioration since 2020
The time series shows a clear worsening after the pandemic phase. The deficit (before coverage measures) moves from –€726 million in 2020 to –€1.1 billion in 2021, exceeds –€1.5 billion in 2022, reaches –€1.74 billion in 2023, and climbs in 2024 to more than –€2.5 billion, marking the most critical point of the 2015–2024 period.

Territories under the greatest pressure
The most severe imbalances are concentrated in special-statute regions and autonomous provinces. In 2024, the Autonomous Province of Bolzano records a deficit of –€472.7 million, while the Autonomous Province of Trentoexceeds –€312 million. Sardinia also posts a significant shortfall at –€332.8 million, albeit on still provisional data.

Persistent weaknesses in the Centre-South
Structural difficulties remain evident elsewhere. Tuscany closes 2024 with a deficit of –€244.4 million, Apulia with –€132.4 million, Calabria with –€118.5 million, and Abruzzo with –€113 million. Piedmont shows a marked deterioration, shifting from a surplus in 2021 to –€192.2 million in 2024.

Lazio as a notable exception
Lazio stands out in the opposite direction, posting a positive balance of +€194.9 million in 2024. The figure confirms the consolidation path pursued in recent years after a long phase of structural deficits and recovery plans.

Pandemic effects have faded
The trend analysis highlights how balance during the pandemic years was supported by extraordinary funding and emergency measures. With those resources now withdrawn, unresolved issues have resurfaced: healthcare inflation, higher energy costs, staff shortages, increased outsourcing of services, and delays in transfers.

Sustainability to be rebuilt
Data from the verification table indicate that the SSN’s financial sustainability remains one of the main challenges ahead. Without a structural strengthening of public funding and stable organisational reforms, the risk is a renewed phase of recovery plans, with direct consequences for the delivery of Essential Levels of Care and for territorial equity.