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Pediatric interregional healthcare mobility in Italy
Mario De Curtis1, Francesco Bortolan2, Davide Diliberto3
1Maternal and Child Health and Urological Sciences Department, University of Rome La Sapienza, Rome, Italy. mario.decurtis@uniroma1.it.
Insights
Children in Italy’s South face higher healthcare mobility and costs due to uneven pediatric care distribution. This highlights a need to strengthen services in Southern regions to ensure equitable access for all children.
Area of Science:
- Healthcare Management
- Pediatric Healthcare
- Regional Health Systems Analysis
Background:
- Interregional healthcare mobility is a key metric for evaluating Regional Healthcare Systems.
- Analysis focuses on the economic and service quality aspects of healthcare mobility.
- The study examines pediatric healthcare mobility in Italy for children up to 14 years old in 2019.
Purpose of the Study:
- To analyze healthcare mobility patterns among children (≤14 years) in Italy in 2019.
- To determine the associated costs of interregional pediatric healthcare mobility.
- To identify disparities in pediatric care access between different Italian regions.
Main Methods:
- Utilized data from the Italian Ministry of Health's "Rapporto annuale sull'attività di ricovero ospedaliero - Dati SDO 2019".
- Collected hospitalization data for all Italian regions, geographically clustered into Center-North and South areas.
- Analyzed the volume and cost of interregional healthcare mobility, particularly from South to Center-North.
Main Results:
- Children in Southern regions had a higher hospitalization rate (13.9%) than those in the Center-North (12.3%).
- Southern children were more frequently treated outside their region (11.9%) compared to Center-North children (6.9%), including for high-complexity cases (21.3% vs 10.5%).
- Passive mobility costs for the South reached €103.9 million, with 87.1% directed to Center-North hospitals; intra-South mobility cost €13.4 million.
Conclusions:
- Healthcare mobility significantly impacts all Italian regions, but is especially pronounced in the South.
- The findings indicate a deficit in pediatric care services within Southern Italy.
- Strengthening pediatric services and improving territorial distribution are crucial to address these disparities.
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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