Abstract
BackgroundThe analysis of interregional healthcare mobility represents one of the main criteria for evaluating Regional Healthcare Systems, both in terms of its economic-financial relevance and the quality and satisfaction of the services provided. The aim of the study is to analyze healthcare mobility and its associated cost in Italy in 2019 for all children ≤ 14 years of age.MethodsWe collected data from the “Rapporto annuale sull’attività di ricovero ospedaliero – Dati SDO 2019” published by the Italian Ministry of Health. These data represent the tool for collecting information relating to all hospitalization services provided in accredited public and private hospitals present throughout the national territory. We collected data for all Italian regions and clustered them in two geographical areas: Center-North regions and South regions (including Sicily and Sardinia). We have analyzed the magnitude of the mobility of children among regions and in particular from the South to the Center-North and the relative cost of this interregional mobility.Results The hospitalization rate of children residing in the South regions was higher than that of children residing in the Center-North regions (13.9% vs 12.3%). Children residing in the South were more frequently treated in other regions than those living in the Center-North (11.9% vs 6.9%). Even considering the high complexity hospitalizations, children living in the South more frequently underwent treatment in other regions (21.3% vs 10.5% of the Center-North). The cost of passive mobility amounts to € 103.9 million for the South regions (15.1% of the total hospitalizations’ expenditure) and the 87.1% of this cost refers to the mobility to the hospitals of Center-North. The cost of healthcare migration from South regions to other South regions was much lower (12.9%, equal to € 13.4 million).ConclusionsHealthcare mobility, while affecting all Italian regions, is particularly relevant in the South regions and indicates a lack of pediatric care, which should be strengthened by creating services that are currently not evenly distributed throughout the territory.
Highlights
The analysis of interregional healthcare mobility represents one of the main criteria for evaluating Regional Healthcare Systems, both in terms of its economic-financial relevance and the quality and satisfaction of the services provided
While homogeneous values are observed considering the volumes of hospitalization on the basis of resident population, with variations from a minimum value of 10.8% in Veneto to a maximum of 15.1% in Lazio, there are important differences between Center-North and South regions
A higher rate of hospitalization was observed among children of South regions (13.9% vs 12.3%)
Summary
The analysis of interregional healthcare mobility represents one of the main criteria for evaluating Regional Healthcare Systems, both in terms of its economic-financial relevance and the quality and satisfaction of the services provided. The provision of services is ensured by a regional network of Local Health Units (Azienda Sanitaria Locale – ASL) and autonomous public and private hospitals In this context, each citizen refers to the Regional Healthcare System in which he resides. The escape index, on the contrary, quantifies the propensity of the patients to move away from their own region in order to take advantage of a healthcare service It is calculated as the proportion between the number of hospital discharges of patients residing in a region and the total number of hospitalizations of residents in that region across the national territory. Foreign citizens and those of unknown nationality are excluded [9]
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