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Inter-Regional Patients’ Migration for Hospital Orthopedic Intensive Rehabilitation: The Italian Experience

Author

Listed:
  • Giovanni Guarducci

    (Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy)

  • Gabriele Messina

    (Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy
    Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy)

  • Simona Carbone

    (General Directorate for Health Planning, Ministry of Health, 01144 Rome, Italy)

  • Andrea Urbani

    (General Directorate for Health Planning, Ministry of Health, 01144 Rome, Italy)

  • Nicola Nante

    (Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy
    Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy)

Abstract

Background: Following the introduction of administrative federalism in the Italian National Health Service, inter-regional patients’ mobility has become increasingly relevant because, in addition to being an indirect index of the quality of care, it has important economic and financial implications. This study aimed to evaluate the fulfillment of the need for hospital orthopedic intensive rehabilitation on site and care-seeking patients’ migration to other regions. Methods: From 2011 to 2019, the data of intensive orthopedic rehabilitation extracts from the Hospital Discharge Cards provided by Italian Ministry of Health were analyzed. We studied the hospital networks of every Italian region (catchment areas). The epidemiological flows of inter-regional mobility were analyzed with Gandy’s Nomogram, while the financial flows were analyzed through Attraction Absorption and Escape Production Indexes. Results: Gandy’s Nomogram showed that only Piedmont, Lombardy, A.P. of Trento, E. Romagna, Umbria and Abruzzo had good public hospital planning for intensive orthopedic rehabilitation, with a positive balance for all studied periods. Lombardy, E. Romagna, Piedmont, Veneto and Latium have absorbed approximately 70% of all financial flows (about EUR 60.5 million). Conclusions: Only six regions appear to be able to satisfy the care needs of their residents, with a positive epidemiological and financial balance for all studied periods.

Suggested Citation

  • Giovanni Guarducci & Gabriele Messina & Simona Carbone & Andrea Urbani & Nicola Nante, 2022. "Inter-Regional Patients’ Migration for Hospital Orthopedic Intensive Rehabilitation: The Italian Experience," IJERPH, MDPI, vol. 19(21), pages 1-11, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:21:p:13726-:d:950281
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    References listed on IDEAS

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    1. Silvia Balia & Rinaldo Brau & Emanuela Marrocu, 2018. "Interregional patient mobility in a decentralized healthcare system," Regional Studies, Taylor & Francis Journals, vol. 52(3), pages 388-402, March.
    2. Brenna, Elenka, 2011. "Quasi-market and cost-containment in Beveridge systems: The Lombardy model of Italy," Health Policy, Elsevier, vol. 103(2), pages 209-218.
    3. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    4. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 577-615.
    5. Rosella Levaggi & Roberto Zanola, 2004. "Patients' migration across regions: the case of Italy," Applied Economics, Taylor & Francis Journals, vol. 36(16), pages 1751-1757.
    6. Diesenreiter, Carina & Österle, August, 2021. "Patients as EU citizens? The implementation and corporatist stakeholders’ perceptions of the EU cross-border health care directive in Austria," Health Policy, Elsevier, vol. 125(11), pages 1498-1505.
    7. David Cantarero, 2006. "Health care and patients’ migration across Spanish regions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(2), pages 114-116, June.
    8. Silvia Bruzzi & Enrico Ivaldi & Marta Santagata, 2022. "Measuring Regional Performance in the Italian NHS: Are Disparities Decreasing?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 159(3), pages 1057-1084, February.
    9. Balia, Silvia & Brau, Rinaldo & Moro, Daniela, 2020. "Choice of hospital and long-distances: Evidence from Italy," Regional Science and Urban Economics, Elsevier, vol. 81(C).
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