Background The Italian National Health System, established in 1978, is inspired by the Beveridge model. Since the 90’s several reforms are taking place introducing, beyond the principle of equity, new elements such as efficacy, efficiency and competitiveness. The devolution to Regional Authority developed a quasi-market system and the emerging empowerment of the citizens, who choose where to be treated, influences financial flows and, indirectly, measures the perceived hospital quality. These aspects are cornerstones for health planning purposes and retrospective studies on cross boundaries patients flows should help health managers in maintaining the dynamic equilibrium among citizen demands and the quasi market rules. Therefore, the aim of this study was to describe the evolution trend of the cross boundaries flows among the 20 Italian Regions. Methods Hospital discharges, 1998-2008, were obtained from the Italian Institute of Statistic. Regional cross boundary flows were studied using the Gandy Nomogram (GN). This tool describes how every Region is able to satisfy its own health care demand and the capacity of attracting patients. Attraction/Escapes rate ratios were calculated (A/E RR). Cuzic’s Test was used to identify significant trends in time. Results All the Italian Regions are located in the balanced quadrant of the GN. 11 regions, mainly southern, over 20 had in all the period attractions rate lower than escapes one (RR<1). Lombardy has the lowest escape rate and the higher rate ratio (>2 in all the studied period). Significant (p<0.05) RR reductions were found in 5 regions: 3 with RR>1(Veneto, Emilia Romagna and Umbria) and 2 (Apulia and Calabria) with a RR<1; 3 regions showed RR increase: 2 with RR<1 (Sicily and Piedmont) and 1 with RR>1 (Lazio). Conclusion The Gandy Nomogram showed that the Italian Regions were generally able to satisfy local healthcare demand. However, differences exist. Southern regions seem less able to hold and attract patients and some of them are getting worse. After healthcare reforms few Regions seems to gain benefit, both for the citizens and financially, some are suffering, and other are still looking for the right directions.

Messina, G., Quercioli, C., Moirano, F., Russo, C., Nante, N. (2011). The effect of healthcare reforms on patients mobility in Italy. EUROPEAN JOURNAL OF PUBLIC HEALTH, 21(1), 52-53.

The effect of healthcare reforms on patients mobility in Italy

MESSINA, G.;QUERCIOLI, C.;NANTE, N.
2011-01-01

Abstract

Background The Italian National Health System, established in 1978, is inspired by the Beveridge model. Since the 90’s several reforms are taking place introducing, beyond the principle of equity, new elements such as efficacy, efficiency and competitiveness. The devolution to Regional Authority developed a quasi-market system and the emerging empowerment of the citizens, who choose where to be treated, influences financial flows and, indirectly, measures the perceived hospital quality. These aspects are cornerstones for health planning purposes and retrospective studies on cross boundaries patients flows should help health managers in maintaining the dynamic equilibrium among citizen demands and the quasi market rules. Therefore, the aim of this study was to describe the evolution trend of the cross boundaries flows among the 20 Italian Regions. Methods Hospital discharges, 1998-2008, were obtained from the Italian Institute of Statistic. Regional cross boundary flows were studied using the Gandy Nomogram (GN). This tool describes how every Region is able to satisfy its own health care demand and the capacity of attracting patients. Attraction/Escapes rate ratios were calculated (A/E RR). Cuzic’s Test was used to identify significant trends in time. Results All the Italian Regions are located in the balanced quadrant of the GN. 11 regions, mainly southern, over 20 had in all the period attractions rate lower than escapes one (RR<1). Lombardy has the lowest escape rate and the higher rate ratio (>2 in all the studied period). Significant (p<0.05) RR reductions were found in 5 regions: 3 with RR>1(Veneto, Emilia Romagna and Umbria) and 2 (Apulia and Calabria) with a RR<1; 3 regions showed RR increase: 2 with RR<1 (Sicily and Piedmont) and 1 with RR>1 (Lazio). Conclusion The Gandy Nomogram showed that the Italian Regions were generally able to satisfy local healthcare demand. However, differences exist. Southern regions seem less able to hold and attract patients and some of them are getting worse. After healthcare reforms few Regions seems to gain benefit, both for the citizens and financially, some are suffering, and other are still looking for the right directions.
2011
Messina, G., Quercioli, C., Moirano, F., Russo, C., Nante, N. (2011). The effect of healthcare reforms on patients mobility in Italy. EUROPEAN JOURNAL OF PUBLIC HEALTH, 21(1), 52-53.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11365/19869
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