What to do in a hospital?
All Italian cities and large towns have at least one clinic (clinica) or hospital (ospedale), indicated by the international sign of a white ‘H’ on a blue background. Public hospitals are listed in the yellow pages under Ospedali and private hospitals under Case di cura private. If your Italian is poor or you prefer to be treated by English-speaking practitioners, the Salvator Mundi International Hospital, Viale Mura Gianicolensi, 67, Rome (Tel. 06-588 961), the Rome American Hospital, Via E. Longoni, 69, Rome (Tel. 06-0622 551) and the Milan Clinic, Via Cerva, 25, Milan (Tel. 02-7601 6047) have English-speaking doctors and staff.
There’s a wide discrepancy between public and private hospital facilities in Italy, although it’s generally considered that there’s little difference between the quality of medical treatment (e.g. surgery). The best hospitals are usually found in northern and central Italy, some of which, e.g. the Cancer Hospital (Centro Tumori) in Rome, have excellent reputations for specialist treatment. There are also a number of highly-regarded university hospitals. Private hospitals (cliniche), many run by the Roman Catholic Church, offer a pleasant alternative to the sometimes grim facilities of public hospitals, although they don’t necessarily have the most sophisticated equipment. Some specialise in particular fields of medicine, such as obstetrics and surgery, rather than being full service hospitals.
A number of private clinics have agreements with regional health authorities and provide beds that can be used by national health patients, although there may be long waiting lists. Public hospitals have a 24-hour accident and emergency (casualty) department (pronto soccorso). Except in emergencies, you may be admitted or referred to a hospital or clinic for treatment only after consultation with a doctor. Normally you’re admitted to a hospital in your own province, unless specialist surgery or treatment is unavailable there. In some regions, if a hospital cannot offer treatment within a reasonable period, patients may be referred to a private clinic without having to pay extra fees.
Under the national health service, you can request that an operation be performed in a hospital in another city, although the best-equipped hospitals in the north of Italy often have long waiting lists. In an emergency outside your own city or province, you will obviously be treated in a local hospital. Your choice of hospital and specialist depends on whether you choose a public or private hospital and the treatment required. A recent law banned private specialists from performing operations in state hospitals. If you’re treated in a public hospital under the national health service, you must be operated on by the medical specialist on duty. If you request the services of a particular specialist or want to avoid a long waiting list for an operation, you must pay the full cost of treatment.
If you need to visit a hospital, don’t expect to be able to find your way easily to the correct ward or consulting room, as few Italian hospitals have reception facilities and signs can be confusing or out-of-date. All patients have the right to an information booklet (carta dei servizi) containing details such as meal schedules, visiting hours, floor plans, doctors’ names, hospital rules, and the location of telephones and toilets. However, the information may not be up-to-date or patient-friendly, and it may be quicker to simply ask the nearest person in a white coat.
Basic accommodation in public hospitals normally consists of wards with between three and six beds, although single bedrooms are usually available with an en suite bathroom for a supplement of between €60 and €75 per day. You can also usually rent a TV for a small daily fee if it isn’t included. Patients normally need to bring everything they need with them, including towels, toiletries, pyjamas or night-dresses and dressing gowns, although meals are provided free of charge. Note, however, that the food may be inedible and you may need some outside assistance (food parcels) if you’re to survive a stay in a public hospital!
In contrast, in private clinics and hospitals, accommodation is generally of luxury hotel standard, with air-conditioned single rooms, TV and telephone, and an extra bed for a relative if required. Public hospitals usually have restricted visiting hours of around two or three hours per day, while private clinics generally have no restrictions. In public hospitals, all in-patient treatment under the national health service is free. For out-patient treatment, e.g. consultations, tests and operations that don’t require you to be hospitalised, you pay the ticket cost, which is a maximum of €36 for each treatment. As with other medical treatment, you must produce a doctor’s referral.
The cost of hospitalisation in a private clinic can be extremely high, e.g. from €500 to €3,000 per day for hospital accommodation (including meals and medicines), plus the costs of medical treatment, e.g. over €5,000 for major surgery. Costs for private operations vary enormously according to the reputation of the specialists involved and the fees they command. Note that it can be much cheaper to have an operation abroad, particularly in France. The Ministry of Health sets minimum charges for all private operations, and specialist treatment information is available from local health authorities). If you have health insurance, be sure to check beforehand whether this covers you for the treatment planned.
If you aren’t covered by the national health service, you must pay before you receive any treatment, irrespective of whether you have private health insurance, although some foreign insurance companies have arrangements with certain hospitals and pay bills directly. If you’re discharged from hospital and don’t have transport to get home, you can usually pay for an ambulance to take you. Volunteer ambulance services such as the Red Cross ( Croce Rossa) provide non-urgent ambulance transport services, for which a list of fees is usually available in hospitals