Assessing Regional Disparities in Chronic Disease Management in three Italian regions

Non-communicable diseases (NCDs) are the leading global cause of mortality and disability, with significant geographic disparities in care processes and outcomes. This study explores chronic disease management across three Italian regions—Lombardy, Sicily, and Tuscany—by analyzing administrative healthcare data from 2017–2018 for patient cohorts with diabetes, heart failure, and stroke. Age- and sex-standardized process indicators were evaluated at the health district level to assess care quality, with spatial patterns analyzed using Moran's I and Geographically Weighted Regression (GWR). Results revealed significant regional and intra-regional variability, particularly in stroke and heart failure care, which showed strong spatial autocorrelation and socioeconomic influences. Diabetes care displayed more uniform distribution, likely reflecting more standardized management practices. The study highlights the need for improved data standardization, equitable healthcare strategies, and enhanced system-level understanding to reduce regional inequalities. Findings align with the objectives of Italy’s National Recovery and Resilience Plan, emphasizing the importance of data-driven policy development for chronic disease management.