Can we interpret the Patient Migrations using the Game Theory?

Background The Patient Migration (PM) is an important phenomenon in the Italian Health System (IHS). In the year 2000 roughly 11% of Italian patients travelled to reach a hospital in a different region from their own. Besides the effects caused by this phenomenon (PM), which go beyond the financial side and sometimes threaten the right of access to the services, it also creates problems of rationing and discrimination. The Italian State, to guarantee an equal possibility of access and the freedom of choice for all patients, uses mainly yardstick competition. In this form the price of its services is fixed and identical for all the suppliers (Local Health Organisations – LHOs) so that the latter use quality to compete in attracting the patients, who are then free to choose and have free access to the market for the largest number of suppliers. This means adopting competitive methods among the LHOs belonging to the various regions and also among the LHOs of the same region.