🇮🇹 Italy Ageing, Long-Term Care & Community Support Knowledge Hub

Italy is undergoing significant demographic change as population ageing, longer life expectancy, lower birth rates and changing family structures create growing demand for long-term care, community support and services that enable people to remain independent. Its approach is shaped by the Servizio Sanitario Nazionale (SSN), regional health systems, municipal social services, home-based care, residential long-term care, cash benefits, private provision, voluntary organisations and a substantial contribution from families and privately employed care workers. The first collection within this Knowledge Hub explores Italy Ageing, Long-Term Care & Community Support, with additional specialist collections being introduced as the library expands.

Italy’s long-term care system is particularly important internationally because responsibility is distributed across national government, Regions and Autonomous Provinces, municipalities, health services, social services, households and private providers. The national government establishes important legislative, health and social protection frameworks, while regional authorities have major responsibilities for organising health services and shaping long-term care provision within their territories. Municipalities also play an important role in social assistance and community support. This creates a complex relationship between national entitlements, regional organisation and local delivery, with practical consequences for access, eligibility, workforce capacity, quality, affordability and geographical inequality.

The Servizio Sanitario Nazionale provides universal health coverage and forms a central part of Italy’s approach to health-related long-term care, but support extends well beyond the health system. People may receive integrated home care, municipal social services, residential and semi-residential provision, rehabilitation, community support and financial assistance. Families continue to provide a substantial proportion of day-to-day care, often supported by privately employed carers, including the widely recognised badante workforce. Cash benefits such as the Indennità di Accompagnamento also play an important role in helping households organise support.

Although Italy has its own constitutional, territorial, cultural and institutional context, many of the pressures affecting its long-term care system are shared internationally. These include rapid population ageing, increasing frailty and dementia, regional inequality, sustainable financing, workforce shortages, reliance on informal care, migration and the care workforce, hospital discharge, health and social care integration, rural access, demand for home-based support, quality assurance, digital transformation, prevention and the transition towards more coordinated and community-based models of care.

This Knowledge Hub has been created to examine the Italian approach to population ageing, long-term care governance, the SSN, regional health systems, municipal social services, financing, assessment and eligibility, home care, residential services, RSA provision, cash benefits, family caregiving, migrant care workers, dementia, frailty, workforce development, quality assurance, safeguarding, hospital discharge, health and social care integration, community health reform, digital health, telecare, prevention, rural access, inequalities and long-term system reform. It forms part of the interconnected international knowledge library across Impact Guru and Impact Insights Hub, supporting comparison between care systems and the practical application of international learning.

As the collection develops, articles will explore how Italy’s long-term care system works; population ageing and demographic change; the responsibilities of national government, Regions and municipalities; financing; the role of the SSN; regional differences; home care; RSA services; family caregiving; the badante model; the Indennità di Accompagnamento; Assistenza Domiciliare Integrata; assessment and eligibility; health and social care integration; dementia; frailty; hospital discharge; Case della Comunità; PNRR investment and reform; workforce shortages; recruitment and retention; quality assurance; safeguarding; digital health and telecare; healthy ageing; rural access; inequalities; national long-term care reform; and the future direction of Italian care and support.

The aim is to build a practical, evidence-informed resource that explains how Italian legislation, national policy, regional governance, municipalities, funding, health services, social services, providers, professionals, families, privately employed carers, communities, technology, governance and evidence interact. Rather than presenting Italy as a model that can simply be transferred elsewhere, the Hub will identify where Italian experience provides useful lessons, where significant regional and structural challenges remain and what international leaders can learn from the country’s continuing development of more integrated, sustainable and community-based long-term care.

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