Characteristics of the health districts in Italy and their implication in primary health care policies: an analysis of socio‐demographic trends


Primary Health Care
Delivery of Healthcare
Population Health Need


The Health District (HD) is a critical component of Italy’s National Health Service, responsible for ensuring Primary Health Care (PHC) services in response to community health needs. The Italian government established a national strategic reform program, the National Recovery and Resilience Plan (PNRR), with a series of health interventions to reorganize the PHC setting (Ministerial Decree 77/2022). Our study aimed to provide a description of socio-demographic data and to assess the correlation between HDs, in order to suggest health intervention priorities in PHC reforms.

We conducted a retrospective analysis using a cross-sectional record linkage of data from multiple sources to compare organizational and socio-demographic variables. A dataset was created with each of the 21 Italian Regions’ HDs data of population, land area, mean age, ageing index, old-age dependency ratio, birth rate and death rate. We then linked the HD data with the Inland Areas Project in order to categorize them from a socio-economic point of view.

Our study identified comparable groups of HDs, considering demographical, socio-economic and geographical aspects.

The study provides a baseline understanding of the Italian situation prior to the implementation of DM77. It also highlights that inhabitants number cannot be the only variable to take into account for the definition of Italian HDs organisation and PHC reform, providing intercorrelated variables that take into account geographic location, demographic data, and socio-economic aspects.


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