Inter-Regional Hospital Patients’ Mobility in Italy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data and Catchment Areas
2.2. Analysis Techniques
- (a).
- The Internal Demand Satisfaction Index (IDSI), which indicates the ratio between the difference between Attractions (A) and Escapes (E) and the sum of Residents (R) and Attractions (A), in formula:IDSI = A − E/(R + A) × 100.
- (b).
- The Attraction Index (AI), which indicates the percentage of Attraction (A) out of the total number of hospitalizations in the Region (A + R), in formula:AI = A/(R + A) × 100.
- (c).
- The Escape Index (EI), which indicates the percentage of Escapes (E) out of the total number of discharges of residents (R + E), in formula:EI = E/(R + E) × 100.
- (d).
- The Attractions Absorption Index (AAI) indicates the percentage of discharges of Attracted from region Xi (with i = 1, ..., 21), out of total Attractions of all regions, in the following formula:AAI Xi = A Xi/Tot. A × 100
- (e).
- The Escape Production Index (EPI) indicates the percentage of Escapes from region Xi (with i = 1,...,21), out of the total Escapes of all regions, in the following formula:IPE Xi = E Xi/Tot. E × 100
- -
- The X value indicates Residents (R) out of Residents (R) plus the Attractions (A):X = R/(R + A) × 100.
- -
- The Y value indicates Residents (R) out of Residents (R) plus the Escapes (E):Y = R/(R + E) × 100.
- -
- Regions placed in the upper left quadrant have a number of residents’ admissions higher than Escapes and, at the same time, lower than Attractions. This condition characterizes regions as “market oriented” (E < R < A), which are able to get more funds because their hospitals admit more patients from other regions than patients from their own. The point (X = 0, Y = 100) identifies the paradoxical condition in which hospitals of a region admit only patients from other regions and there are no Escapes.
- -
- The upper right quadrant is parted in two areas: a and b. In the first one, the residents’ admissions are higher than Attractions and the latter are higher than Escapes (E < A < R). In the second area, residents’ admissions are higher than Escapes, but the latter are higher than attracted (A < E < R).
- -
- In the lower left quadrant, a diagonal divided it in two areas. Both of them have a lower number of residents’ admissions, exceeded by Escapes and Attractions: in the upper area, Escapes are lower than Attractions (R < E < A) and in the lower, we have an opposite situation (R < A < E).
- -
- The lower right quadrant shows regions where residents’ admissions are lower than Escapes and higher than Attractions (A < R < E).
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Year | Residents | Mobility | Total | Total (ORD + DH) | |||
---|---|---|---|---|---|---|---|
Ordinary | Day Hospital | Ordinary | Day Hospital | Ordinary | Day Hospital | ||
2013 | 6,031,991 | 2,139,284 | 498,214 | 175,638 | 6.530,205 | 2,314,922 | 8,845,127 |
2014 | 5,890,301 | 1,993,205 | 495,361 | 183,449 | 6,385,662 | 2,176,654 | 8,562,136 |
2015 | 5,780,827 | 1,868,755 | 502,274 | 178,975 | 6,283,101 | 2,047,730 | 8,330,831 |
2016 | 5,660,277 | 1,552,413 | 507,425 | 175,832 | 6,167,072 | 1,728,245 | 7,895,947 |
2017 | 5,627,008 | 1,634,522 | 507,841 | 168,288 | 6,134,849 | 1,802,810 | 7,937,659 |
Region | 2013 | 2104 | 2015 | 2016 | 2017 | Mean | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
R | M | R | M | R | M | R | M | R | M | R | M | |
Piedmont | 3.10 | 3.83 | 3.24 | 4.33 | 3.44 | 4.43 | 3.46 | 4.68 | 3.50 | 4.73 | 3.35 ± 0.17 | 4.40 ± 0.32 |
Aosta Valley | 2.21 | 2.30 | 2.21 | 2.21 | 2.05 | 2.18 | 2.42 | 1.95 | 2.58 | 1.71 | 2.29 ± 0.21 | 2.07 ± 0.21 |
Lombardy | 5.65 | 5.18 | 4.95 | 4.36 | 5.01 | 4.08 | 4.90 | 3.97 | 4.90 | 4.06 | 5.08 ± 0.32 | 4.33 ± 0.44 |
A.P. Bolzano | 3.47 | 2.82 | 3.64 | 2.69 | 3.73 | 3.35 | 3.68 | 3.65 | 3.75 | 3.74 | 3.65 ± 0.11 | 3.25 ± 0.43 |
A.P. Trento | 1.96 | 2.94 | 1.98 | 3.28 | 2.10 | 3.51 | 2.23 | 3.68 | 2.31 | 4.08 | 2.12 ± 0.15 | 3.50 ± 0.38 |
Veneto | 3.24 | 2.23 | 3.35 | 2.16 | 3.40 | 2.32 | 3.93 | 2.62 | 4.81 | 3.23 | 3.75 ± 0.65 | 2.51 ± 0.39 |
Friuli V.G. | 3.34 | 1.28 | 3.49 | 1.37 | 3.58 | 1.62 | 3.74 | 1.78 | 3.81 | 1.68 | 3.59 ± 0.19 | 1.55 ± 0.19 |
Liguria | 1.96 | 1.18 | 1.99 | 1.17 | 2.06 | 1.17 | 2.04 | 1.24 | 2.81 | 1.57 | 2.17 ± 0.36 | 1.27 ± 0.15 |
E. Romagna | 3.17 | 3.50 | 3.28 | 3.66 | 3.39 | 3.66 | 3.53 | 3.84 | 4.67 | 4.81 | 3.60 ± 0.61 | 3.89 ± 0.47 |
Tuscany | 3.14 | 2.91 | 3.16 | 2.85 | 3.08 | 2.68 | 3.10 | 2.62 | 3.15 | 2.61 | 3.12 ± 0.03 | 2.73 ± 0.12 |
Umbria | 4.54 | 3.55 | 4.85 | 4.33 | 4.91 | 4.90 | 4.44 | 4.09 | 4.22 | 4.13 | 4.59 ± 0.29 | 4.20 ± 0.43 |
Marche | 3.16 | 3.10 | 3.25 | 3.61 | 3.31 | 3.95 | 3.25 | 3.85 | 2.97 | 2.33 | 3.19 ± 0.13 | 3.37 ± 0.60 |
Latium | 1.97 | 1.37 | 2.06 | 1.35 | 2.12 | 1.37 | 2.25 | 1.47 | 2.26 | 1.44 | 2.13 ± 0.12 | 1.40 ± 0.05 |
Abruzzo | 2.67 | 2.03 | 2.73 | 1.91 | 3.20 | 2.25 | 3.30 | 2.26 | 3.45 | 2.27 | 3.07 ± 0.35 | 2.15 ± 0.15 |
Molise | 2.12 | 2.26 | 2.07 | 2.37 | 2.25 | 2.27 | 2.93 | 2.57 | 3.04 | 2.57 | 2.48 ± 0.46 | 2.41 ± 0.14 |
Campania | 1.60 | 1.95 | 1.70 | 2.14 | 1.76 | 2.23 | 1.79 | 2.21 | 1.84 | 2.29 | 1.74 ± 0.09 | 2.16 ± 0.12 |
Apulia | 3.67 | 5.08 | 4.02 | 5.24 | 5.19 | 6.98 | 6.94 | 8.76 | 9.02 | 9.84 | 5.77 ± 2.22 | 7.18 ± 1.88 |
Basilicata | 3.21 | 2.45 | 3.29 | 2.89 | 3.37 | 3.24 | 3.25 | 3.21 | 3.53 | 3.21 | 3.33 ± 0.13 | 3.00 ± 0.30 |
Calabria | 2.36 | 2.36 | 2.61 | 2.46 | 2.77 | 2.70 | 3.00 | 3.25 | 3.39 | 4.50 | 2.83 ± 0.39 | 3.06 ± 0.79 |
Sicily | 2.52 | 2.54 | 3.54 | 3.68 | 3.93 | 3.86 | 4.03 | 3.49 | 4.13 | 4.16 | 3.63 ± 0.66 | 3.55 ± 0.55 |
Sardinia | 2.55 | 5.30 | 2.46 | 5.14 | 2.41 | 6.22 | 2.42 | 6.05 | 2.46 | 5.67 | 2.46 ± 0.06 | 5.68 ± 0.42 |
Total | 2.82 | 2.67 | 2.96 | 2.70 | 3.09 | 2.79 | 3.22 | 2.88 | 3.44 | 3.01 | 3.11 ± 0.24 | 2.81 ± 0.13 |
N | Description | 2013 | 2014 | 2015 | 2016 | 2017 |
---|---|---|---|---|---|---|
1 | Diseases and Disorders of the Nervous System | 46,877 | 47,124 | 43,643 | 47,170 | 46,682 |
2 | Diseases and Disorders of the Eye | 30,894 | 26,780 | 25,127 | 25,459 | 24,362 |
3 | Diseases and Disorders of the Ear, Nose, Mouth and Throat | 31,796 | 32,193 | 32,167 | 30,993 | 30,522 |
4 | Diseases and Disorders of the Respiratory System | 26,029 | 27,582 | 29,240 | 27,442 | 27,590 |
5 | Diseases and Disorders of the Circulatory System | 65,500 | 64,712 | 63,968 | 65,735 | 64,215 |
6 | Diseases and Disorders of the Digestive System | 43,024 | 43,390 | 43,940 | 43,590 | 43,497 |
7 | Diseases and Disorders of the Hepatobiliary System and Pancreas | 22,097 | 22,043 | 22,318 | 22,479 | 22,540 |
8 | Diseases and Disorders of the Musculoskeletal System and Connective Tissue | 150,648 | 157,980 | 160,552 | 164,076 | 160,989 |
9 | Diseases and Disorders of the Skin, Subcutaneous Tissue and Breast | 26,211 | 26,552 | 27,940 | 28,133 | 27,638 |
10 | Diseases and Disorders of the Endocrine, Nutritional and Metabolic System | 25,482 | 25,831 | 27,284 | 28,028 | 29,137 |
11 | Diseases and Disorders of the Kidney and Urinary Tract | 32,063 | 31,856 | 32,874 | 32,238 | 32,744 |
12 | Diseases and Disorders of the Male Reproductive System | 15,731 | 15,725 | 16,634 | 16,876 | 16,273 |
13 | Diseases and Disorders of the Female Reproductive System | 31,324 | 33,592 | 33,616 | 34,036 | 33,498 |
14 | Pregnancy, Childbirth And Puerperium | 29,023 | 29,191 | 28,527 | 27,028 | 25,826 |
15 | Newborn And Other Neonates (Perinatal Period) | 4585 | 4318 | 4249 | 3961 | 3914 |
16 | Diseases and Disorders of the Blood/Blood Forming Organs and Immunological Disorders | 7184 | 6986 | 6932 | 6629 | 6528 |
17 | Myeloproliferative Diseases and Disorders (Poorly Differentiated Neoplasms) | 37,233 | 36,823 | 36,255 | 33,857 | 30,909 |
18 | Infectious and Parasitic Diseases and Disorders (Systemic or unspecified sites) | 5659 | 5875 | 6208 | 6235 | 6379 |
19 | Mental Diseases and Disorders | 13,266 | 13,294 | 12,484 | 12,566 | 13.488 |
20 | Alcohol/Drug Use or Induced Mental Disorders | 1261 | 1211 | 1234 | 1333 | 2137 |
21 | Injuries, Poison, and Toxic Effect of Drugs | 5473 | 5655 | 5296 | 5421 | 5357 |
22 | Burns | 366 | 436 | 439 | 410 | 441 |
23 | Factors Influencing Health Status and Other Contacts with Health Services | 14,588 | 14,697 | 16,086 | 16,211 | 16,457 |
24 | Multiple Significant Trauma | 485 | 523 | 512 | 625 | 623 |
25 | Human Immunodeficiency Virus Infection | 1109 | 986 | 837 | 709 | 708 |
Total | 669,921 | 675,355 | 678,362 | 681,240 | 674,471 |
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Nante, N.; Guarducci, G.; Lorenzini, C.; Messina, G.; Carle, F.; Carbone, S.; Urbani, A. Inter-Regional Hospital Patients’ Mobility in Italy. Healthcare 2021, 9, 1182. https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9091182
Nante N, Guarducci G, Lorenzini C, Messina G, Carle F, Carbone S, Urbani A. Inter-Regional Hospital Patients’ Mobility in Italy. Healthcare. 2021; 9(9):1182. https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9091182
Chicago/Turabian StyleNante, Nicola, Giovanni Guarducci, Carlotta Lorenzini, Gabriele Messina, Flavia Carle, Simona Carbone, and Andrea Urbani. 2021. "Inter-Regional Hospital Patients’ Mobility in Italy" Healthcare 9, no. 9: 1182. https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare9091182