1. Introduction

Unfortunately, increasing healthcare waiting times seems to be one of the characteristics of many nowadays health systems. There is evidence that such phenomenon affects the efficiency and accessibility of the system, negatively affecting patient outcomes as well as healthcare costs and creating public distrust in the system [2]. Although Italy and Sweden provide universal healthcare, they have different approaches in managing patient flow and resources. Even if Sweden has always been known for its remarkable health and social system, it is now experiencing record delays and increasing waiting lists due to rising demand and inefficient data use [9]. At the same time, Italy continues to struggle with regional inequalities, workforce shortages, and fragmented governance [8]. Key objectives of this study:

The study evaluates Italy’s NADEF 2025 framework, Sweden’s €6.5 billion investment, and the role of PNRR (Next Generation EU) funding in Italy [6]. It also discusses the importance of LEA (Essential Levels of Care) and LEP (Essential Levels of Performance) in shaping healthcare policy [7].

Access to timely healthcare services is a fundamental aspect of an efficient and equitable healthcare system. However, prolonged waiting times can lead to worsened health outcomes, increased patient dissatisfaction, and inefficiencies in resource allocation. Both Italy and Sweden, despite offering universal healthcare, are grappling with rising waiting times, albeit due to different structural and systemic challenges.

2.1 The Italian System: Structural Weaknesses and the Role of Next Generation EU (PNRR) Italy’s National Health Service (NHS) ensures universal coverage but suffers from many weaknesses, such as the inability to manage waiting times due to:

2.2 The Swedish System: A Model Under Pressure

Sweden has traditionally been known for its efficient healthcare system, but recent trends indicate a growing crisis in waiting times [10] caused by:

To combat these issues, the Swedish government has allocated €6.5 billion to address inefficiencies, focusing on:

While these initiatives show promise, Sweden still struggles with retaining healthcare professionals and effectively integrating digital tools [1].

Addressing healthcare waiting times requires a combination of strategic policy interventions, targeted investments, and systemic reforms. Both Italy and Sweden have introduced various measures to tackle growing delays in patient care, yet the effectiveness of these initiatives remains uncertain. While Sweden is making substantial financial commitments, Italy is relying on long-term structural reforms through national and EU-backed funding programs.

3.1 Italy: The Role of NADEF 2025 and PNRR in Reducing Waiting Times

In Italy, the recent budget allocated to healthcare amounted to €3 billion and it has been designated for systemic improvements [6]. However, not all of these funds are directly allocated to reducing waiting times. The policy measures focus on:

3.2 Sweden: A High-Investment Approach

The government has recently voted for a €6.5 billion investment plan in Sweden. The ambitious helth plan aims to:

A mathematical efficiency measure is proposed:

EFFICIENCY = (Investment x Resources Utilization)/(Average Waiting Times x Unmet Needs)

where EFFICIENCY represents the efficiency score. This model considers the natural inverse relationship between a country’s healthcare investments and the reduction in waiting times and improved service delivery.

A Python-based simulation has been developed to test different policy scenarios and their impact on waiting list efficiency.

4.1 Efficiency Simulation Graph Analysis

The following graph illustrates the impact of investment increases (+10%, +20%, and +30%) on efficiency scores for Italy and Sweden under different waiting time scenarios:

Graph 1: Efficiency Impact of Investment on Waiting Times in Italy and Sweden (see the appendix for the Python Code generating the graph)

Interpretation of the Graph:

1. Investment Increase and Efficiency: The graph shows that as investment increases (from an hypothetical +10% to +30%), efficiency scores improve, more in Sweden (dashed curves) with respect to Italy.
2. Impact of Waiting Times: it rather intuitive to think that as waiting times decrease, efficiency increases. This highlights the importance of reducing delays in specialist and hospital care services.
3. Comparison Between Countries: Sweden exhibits a higher efficiency curve compared to Italy, even with similar investment increases. This suggests that Sweden’s resource utilization and digital patient management systems are more effective in translating funding into improved healthcare access.
4. Diminishing Returns: The graph also indicates diminishing returns on efficiency when investment increases beyond a certain point. As a result structural healthcare reforms are more efficient tools than simply injections of financial resources, to optimize patient flow and staff allocation.

This efficiency model provides a data-driven approach to guiding policy decisions, ensuring that investments in Italy and Sweden are strategically allocated to achieve maximum impact on waiting times.

5. Conclusion

Healthcare waiting times remain a pressing challenge for both Italy and Sweden. Despite their universal healthcare systems, both countries struggle with inefficiencies stemming from resource allocation, staff shortages, and demographic pressures [2]. Italy’s regional disparities and delayed implementation of Case della Comunità continue to hinder progress, while Sweden faces a growing burden due to increased demand and inefficiencies in digital integration [9].

Key insights from this study include:

Based on the analysis, the following policy recommendations are proposed: