Introduction or preface

The Italian Observatory Healthcare Report (IOHR - 9th edition) collects comparable data on health status and quality of healthcare services throughout Italy and supply policy makers with a set of indicators validated at international level in order to help them in the decision making process. The present IOHR aims to describe quality of healthcare and the effects of the economic crisis on health. The report realizes a benchmarking activity and indicators selected are analyzed according to: meaning, feasibility and quality, comparability and reliability. Each indicator is validated by a panel of public health experts in terms of meaning, pattern, validity and limits; graphic representations and recommendations for decision makers are included and a peer reviewing is performed for quality assessment. Indicators on population dynamics, survival, cardiovascular diseases, cancer, infectious diseases show that the overall health status of Italians is good, nevertheless, changes in lifestyles, diet and healthcare supply are evident and out of pocket expenses are growing as well as anti-depressant drugs consumption and suicides. Regional differences are constant and economic crisis might increase inequalities. The IOHR describes the overall health status in Italy as good, nevertheless, the effects of economic crisis on health are already visible: it is necessary to stimulate the provision of preventive services and ad hoc social and health policies in order to prevent citizens to become ill and reduce differences between geographical macro-areas, regions and gender that are widening