Pediatric interregional healthcare mobility in Italy

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Abstract

Background

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 aim of the study is to analyze healthcare mobility and its associated cost in Italy in 2019 for all children ≤ 14 years of age.

Methods

We 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).

Conclusions

Healthcare 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.

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Most cited references 18

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Italy: health system review.

Francesca Ferre, Antonio Giulio de Belvis, Luca Valerio … (2014)

Italy is the sixth largest country in Europe and has the second highest average life expectancy, reaching 79.4 years for men and 84.5 years for women in 2011. There are marked regional differences for both men and women in most health indicators, reflecting the economic and social imbalance between the north and south of the country. The main diseases affecting the population are circulatory diseases, malignant tumours and respiratory diseases. Italy's health care system is a regionally based national health service that provides universal coverage largely free of charge at the point of delivery. The main source of financing is national and regional taxes, supplemented by copayments for pharmaceuticals and outpatient care. In 2012, total health expenditure accounted for 9.2 percent of GDP (slightly below the EU average of 9.6 percent). Public sources made up 78.2 percent of total health care spending. While the central government provides a stewardship role, setting the fundamental principles and goals of the health system and determining the core benefit package of health services available to all citizens, the regions are responsible for organizing and delivering primary, secondary and tertiary health care services as well as preventive and health promotion services. Faced with the current economic constraints of having to contain or even reduce health expenditure, the largest challenge facing the health system is to achieve budgetary goals without reducing the provision of health services to patients. This is related to the other key challenge of ensuring equity across regions, where gaps in service provision and health system performance persist. Other issues include ensuring the quality of professionals managing facilities, promoting group practice and other integrated care organizational models in primary care, and ensuring that the concentration of organizational control by regions of health-care providers does not stifle innovation.

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Globalization and healthcare: understanding health and medical tourism.

John F. P. Bridges, M Carrera (2006)

Faced with long waiting lists, the high cost of elective treatment and fewer barriers to travel, the idea of availing healthcare in another country is gaining greater appeal to many. The objective of this review is to perform a literature review of health and medical tourism, to define health and medical tourism based on the medical literature and to estimate the size of trade in healthcare. The Medline database was used for our literature review. In our initial search for 'health tourism' and 'medical tourism' we found a paucity of formal literature as well as conceptual ambiguity in the literature. Subsequently, we reviewed the literature on 'tourism' in general and in the context of healthcare. On the basis of 149 papers, we then sought to conceptualize health tourism and medical tourism. Based on our definitions, we likewise sought to estimate market capacity internationally. We defined health tourism as "the organized travel outside one's local environment for the maintenance, enhancement or restoration of an individual's wellbeing in mind and body". A subset of this is medical tourism, which is "the organized travel outside one's natural healthcare jurisdiction for the enhancement or restoration of the individual's health through medical intervention". At the international level, health tourism is an industry sustained by 617 million individuals with an annual growth of 3.9% annually and worth US$513 billion. In conclusion, this paper underscored the issue of a severely limited formal literature that is compounded by conceptual ambiguity facing health and medical tourism scholarship. In clarifying the concepts and standardizing definitions, and providing evidence with regard to the scale of trade in healthcare, we hope to assist in furthering fundamental research tasks, including the further development of reliable and comparable data, the push and pull factors for engaging in health and medical tourism, and the impact of health tourism but, more so, medical tourism on local healthcare systems.

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How health care regionalisation in Italy is widening the North-South gap.

Federico Toth (2014)

The Italian National Health Service began experimenting with a significant regionalisation process during the 1990s. The purpose of this article is to assess the effects that this regionalisation process is having on the rift between the north and the south of the country. Has the gap between the health care systems of the northern and southern regions been increasing or decreasing during the 1999-2009 decade? Three indicators will be utilised to answer this question: (1) the level of satisfaction expressed by the citizens towards the regional hospital system; (2) the mobility of the patients among regions; (3) the health care deficit accumulated by the individual regions. On the basis of these three indicators, there is evidence to conclude that, during the decade under study, the gap between the North and the South, already significant, has increased further.

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Author and article information

Contributors

Mario De Curtis:

ORCID: http://orcid.org/0000-0001-9990-3071

mario.decurtis@uniroma1.it

Journal

Journal ID (nlm-ta): Ital J Pediatr

Journal ID (iso-abbrev): Ital J Pediatr

Title: Italian Journal of Pediatrics

Publisher: BioMed Central (London )

ISSN (Electronic): 1824-7288

Publication date (Electronic): 24 June 2021

Publication date PMC-release: 24 June 2021

Publication date Collection: 2021

Volume: 47

Electronic Location Identifier: 139

Affiliations

[1 ]GRID grid.7841.a, Maternal and Child Health and Urological Sciences Department, , University of Rome La Sapienza, ; Rome, Italy

[2 ]AGE.NA.S. (AGEnzia NAzionale per i Servizi sanitari regionali), Rome, Italy

[3 ]GRID grid.466998.c, ISNI 0000 0001 2369 6475, Azienda Zero, Regione del Veneto, ; Padua, Italy

[4 ]GRID grid.8142.f, ISNI 0000 0001 0941 3192, Section of Hygiene, University Department of Life Sciences and Public Health — Università Cattolica del Sacro Cuore, ; Rome, Italy

Author information

Mario De Curtis http://orcid.org/0000-0001-9990-3071

Article

Publisher ID: 1091

DOI: 10.1186/s13052-021-01091-8

PMC ID: 8223326

PubMed ID: 34167569

SO-VID: 7273e03d-a442-46db-ba52-553f3f3328a5

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 26 March 2021

Date accepted : 30 May 2021

Custom metadata

ScienceOpen disciplines: Pediatrics

Keywords: pediatric population,healthcare mobility,healthcare mobility costs,hospitalizations

Data availability:

ScienceOpen disciplines: Pediatrics

Keywords: pediatric population, healthcare mobility, healthcare mobility costs, hospitalizations

Pediatric interregional healthcare mobility in Italy

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Pediatric Pulse: Advancing Neonatal and Child Health

Most cited references 18

Italy: health system review.

Globalization and healthcare: understanding health and medical tourism.

How health care regionalisation in Italy is widening the North-South gap.

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