Inter-Regional Patients' Migration for Hospital Orthopedic Intensive Rehabilitation: The Italian Experience.
GIS
Gandy’s Nomogram
Italian National Health Service
Italian regions
health policy
health services quality and financing
intensive orthopedic rehabilitation
patient’s mobility
Journal
International journal of environmental research and public health
ISSN: 1660-4601
Titre abrégé: Int J Environ Res Public Health
Pays: Switzerland
ID NLM: 101238455
Informations de publication
Date de publication:
22 10 2022
22 10 2022
Historique:
received:
12
09
2022
revised:
18
10
2022
accepted:
19
10
2022
entrez:
11
11
2022
pubmed:
12
11
2022
medline:
15
11
2022
Statut:
epublish
Résumé
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. 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. 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). 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.
Sections du résumé
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.
Identifiants
pubmed: 36360606
pii: ijerph192113726
doi: 10.3390/ijerph192113726
pmc: PMC9655827
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Références
Health Policy. 2021 Nov;125(11):1498-1505
pubmed: 34526232
Eur J Health Econ. 2006 Jun;7(2):114-6
pubmed: 16477461
BMC Health Serv Res. 2013 Feb 12;13:56
pubmed: 23399540
Int J Health Policy Manag. 2014 May 14;2(4):155-7
pubmed: 24847479
Patient Educ Couns. 2021 Oct;104(10):2559-2564
pubmed: 33726985
Healthcare (Basel). 2021 Sep 08;9(9):
pubmed: 34574956
Ann Ig. 2015 Sep-Oct;27(5):769-76
pubmed: 26661918
Ann Ig. 2016 Sep-Oct;28(5):328-38
pubmed: 27627664
J Health Organ Manag. 2020 Jan 20;ahead-of-print(ahead-of-print):
pubmed: 32017847
Int J Environ Res Public Health. 2022 Mar 09;19(6):
pubmed: 35328918
Health Serv Manage Res. 2010 Nov;23(4):172-80
pubmed: 21097728
HPB (Oxford). 2014 Jun;16(6):543-9
pubmed: 24245982
Ann R Coll Surg Engl. 2022 Jun;104(6):443-448
pubmed: 34939832
Health Place. 2010 Nov;16(6):1145-55
pubmed: 20729128
J Health Econ. 2016 Dec;50:372-387
pubmed: 27344297
Econ J (London). 2011 Aug;121(554):F228-F260
pubmed: 25821239
Hosp Health Serv Rev. 1979 Feb;75(2):50-1
pubmed: 10240512
Health Serv Manage Res. 2021 Nov;34(4):258-268
pubmed: 33032454
Health Serv Res. 2003 Dec;38(6 Pt 1):1403-21
pubmed: 14727780
Health Policy. 2011 Dec;103(2-3):209-18
pubmed: 22030307
Int J Health Geogr. 2018 Aug 2;17(1):32
pubmed: 30071864
Health Policy Open. 2022 Dec;3:100064
pubmed: 35036910
Int J Health Policy Manag. 2015 Aug 25;4(12):857-9
pubmed: 26673474
Soc Indic Res. 2022;159(3):1057-1084
pubmed: 34483439
Health Policy. 2014 Jul;117(1):90-7
pubmed: 24726508
Int J Health Policy Manag. 2015 Mar 20;4(6):363-72
pubmed: 26029895
Lancet. 2018 Nov 3;392(10158):1662-1671
pubmed: 30496081