The reform of territorial health care planned under the PNRR (Health Mission) remains far from being fully operational. As of December 31, 2025, only 66 Community Health Centers (3.9%) are fully operational, while 163 Community Hospitals (27.4%) have activated at least one service, but none are fully operational. On the digital front, the Electronic Health Record (EHR) remains incomplete and underused, particularly due to citizens’ lack of consent, especially in Southern Italy.
The GIMBE Observatory continues its independent monitoring of the Health Mission’s implementation. “We analyzed—says Nino Cartabellotta, president of the GIMBE Foundation—the results as of December 30, 2025 and the issues that slow the reform. The goal is to provide an objective picture and to issue a warning to the Government and the Regions about the risks tied to the delays accumulated.”
Territorial Care: State of the Art and Challenges
Four years after the DM 77 decree, the reform is progressing slowly, with pronounced regional inequalities. “The strengthening of territorial care,” Cartabellotta says, “is essential to relieve hospitals and emergency departments. However, official data paint a worrying picture: we are still far from meeting European targets.”
The reorganization envisions 1,715 Community Health Centers, 657 Territorial Operations Centers, and 594 Community Hospitals, but PNRR funding covers only a portion of the planned facilities. In particular, more than a third of Community Health Centers have not activated any service, and only 16.7% offer all those envisaged. Fully operational facilities are barely 3.9%. “The partial presence of services,” Cartabellotta comments, “weakens the functions of Community Health Centers and makes them unattractive to citizens.” The main constraint remains staff shortages: “Even where services are active, Community Health Centers remain hollow boxes.”
Edwardically, the Community Hospitals face an even more critical situation: only 27.4% have activated at least one service and none are fully operational. “These numbers—observes the GIMBE president—confirm that we are significantly behind schedule and that meeting the deadlines will be difficult.”
The only positive note concerns the Territorial Operational Centers, for which the European target has been reached, with 625 fully functioning facilities.
Electronic Health Record and Risks to the Health Mission
Critical issues persist also on the digital front. “Without real interoperability,” explains Cartabellotta, “the EHR cannot generate real benefits for care.” Only 44% of citizens have expressed consent to consult their EHR, with strong regional differences. “If less than half of citizens permit access to their own EHR,” he warns, “we are facing a cultural and organizational problem.”
“A few months before the final reporting of the Health Mission,” Cartabellotta concludes, “the risk is triple: not reaching European targets, widening regional inequalities, and not producing tangible benefits for citizens. We risk wasting a historic opportunity for the SSN.”
Abbonati a Karla Miller
