Indicatori per l’analisi della mobilità passiva extraregionale

Abstract

Passive extra-regional healthcare mobility represents a critical issue for Regional Health Services, as it expresses a demand for hospitalisation that is met outside the territory of competence, with significant organisational and economic implications. In this paper, we propose a pair of summary indicators for assessing passive extra-regional mobility: the ratio between hospitalisations lost and hospitalisations gained (F/P-Vol.) and the ratio between economic value lost and economic value gained (F/P-Val.). ‘Outflow’ refers to hospitalisations provided by facilities located outside the region to citizens assisted by the ASL; “inflow” refers to the total number of hospitalisations and the value generated by accredited public and private facilities in the company’s territory. The indicators make it possible to quantify the weight of demand met outside the region compared to the total demand met, both in terms of volume and resources absorbed, and to compare ASLs and individual DRGs. Application to a group of Piedmont ASLs on five high-flight DRGs shows how the combined trend of F/P-Vol. and F/P-Val. allows critical situations to be identified, as well as systematic differences between the average value of flight admissions and production. Finally, a statistical formalisation based on the Delta method is proposed to estimate the standard error of the F/P-Vol. indicator, which is useful for distinguishing random fluctuations from systematic variations.