ORIGINAL RESEARCH article

Front. Public Health

Sec. Aging and Public Health

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1575330

This article is part of the Research TopicEnhancing Geriatric Care: International Collaboration and Best Practices for Aging PopulationsView all 14 articles

Reforming Italy's long-term care system: the role of barriers to and drivers of the use of services at the local level

Provisionally accepted
Sara SantiniSara Santini1Gianluca BusilacchiGianluca Busilacchi2Giovanni LamuraGiovanni Lamura1Federico SofrittiFederico Sofritti2Antonio PacificoAntonio Pacifico2*Ramona BongelliRamona Bongelli2Carmela GuarascioCarmela Guarascio2
  • 1Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Ancona, Ancona, Italy
  • 2University of Macerata, Macerata, Italy

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In Italy, population ageing is causing an unprecedented demand for long-term care (LTC) services, that led to the recent national reform of the LTC system (Law n. 33/2023). Since LTC services are provided by regional authorities, identifying drivers of and barriers to their use by older people and their family caregivers locally is very important to identify the mismatch between national regulation and local demand of these services. To this purpose, in 2019-2020, 450 family caregiver (FC)-older care recipient (OCR) dyads from 13 healthcare districts of the Marche region (Central Italy) were surveyed. A Two-step Bayesian Multiclass procedure was used for the analysis. The main drivers of the use of healthcare services are FC's age and gender (being a man), and OCR's age and level of disability. The main barrier to the use of private services is their cost, while for the public ones is their unavailability. The most common private service is represented by migrant care workers (MCWs), hired privately by the older people's families. Findings suggest that the recent national LTC reform in Italy does not seem to have fully captured the LTC needs of older people, and some policy suggestions are therefore provided in this regard.

Keywords: long-term care system1, barriers to long-term care services2, drivers to long-term care services3, long-term care reform4, care dyad5, older people with long-term care needs6 Allineato a sinistra Eliminato: The national Italian

Received: 12 Feb 2025; Accepted: 31 Mar 2025.

Copyright: © 2025 Santini, Busilacchi, Lamura, Sofritti, Pacifico, Bongelli and Guarascio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Antonio Pacifico, University of Macerata, Macerata, Italy

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