Post Graduate School of Public Health, University of Siena, 53100 Siena, Italy.
Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy.
Int J Environ Res Public Health. 2022 Oct 22;19(21):13726. doi: 10.3390/ijerph192113726.
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.
在意大利国家卫生服务引入行政联邦制后，地区间患者的流动性变得越来越重要，因为这不仅是医疗服务质量的间接指标，而且具有重要的经济和财务影响。本研究旨在评估现场提供医院骨科强化康复服务的满足程度以及寻求医疗服务的患者向其他地区的迁移情况。
从 2011 年到 2019 年，分析了意大利卫生部提供的住院患者出院记录中的骨科强化康复提取数据。我们研究了每个意大利地区（服务区）的医院网络。通过甘迪诺图分析了地区间流动的流行病学流，而通过吸引力吸收和逃逸生产指数分析了财务流。
甘迪诺图显示，只有皮埃蒙特、伦巴第、特伦托自治省、艾米利亚-罗马涅、翁布里亚和阿布鲁佐地区在骨科强化康复方面有良好的公立医院规划，所有研究期间均保持正平衡。伦巴第、艾米利亚-罗马涅、皮埃蒙特、威尼托和拉齐奥地区吸收了大约 70%的所有资金流（约 6050 万欧元）。
只有六个地区似乎能够满足其居民的护理需求，所有研究期间均保持正的流行病学和财务平衡。
