Characterization and burden of Campania children health migration across Italian regions during years 2006–2010: chance and/or necessity?

Italian Journal of Pediatrics

Attilio Montano Bianchi¹  Virginia Scafarto¹  Giuseppe Masullo⁵  Claudio Pinto⁴  Tullia Saccheri⁵  Giuseppe Longo³  Egidio Celentano³  Giulia Paolella²  Pietro Vajro² 

[1] University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy;Chair of Pediatrics, Medical School of the University of Salerno, Salerno, Italy;ArSan, Regional Health Agency of Campania Region, Naples, Italy;Department of Economics and Statistics Science, University of Salerno, Salerno, Italy;Department of Human Science, Philosophy and Education (DISUFF), University of Salerno, Salerno, Italy

关键词: Interregional mobility;    Health migration;    Children;    Southern Italy;    Campania region;   

Others  :  825624
DOI  :  10.1186/1824-7288-38-58

 received in 2012-09-13, accepted in 2012-10-11,  发布年份 2012

【 摘 要 】

Background

To evaluate medical, economical and sociological variables underlying avoidable pediatric migration from Campania region.

Methods

Analysis of years 2006–2010 hospital discharge records, extracted from the archive of Regional Health Agency (ArSan), classified by Major Diagnostic Categories, Aggregate Clinical Codes, Discipline of dismissal, Local Health Authorities of residence, and age group 0–14 years (excluding those of healthy newborns). Sociological variables were evaluated by questionnaires.

Results

A total of 68,316 hospital discharge records were released by extra-regional structures. Major diagnostic categories and Discipline of dismissal indicated that the most implicated diseases (nervous system and mental disorders, hematology-oncology, and bone diseases) were not always of very high complexity. The total cost paid by the Campania Region was 124.700.000 Euros. The need for more specialized hospital pediatric units and/or with more pediatric subspecialties in the native region was pointed out by most of the self-administered questionnaires.

Conclusions

Pediatric migration is an important phenomenon with evident implications. The identification of the most concerned sub-specialties here reported can give useful information aiming to assist in the improvement of the existing pediatric resources in Campania region in the wider context of the national global child health advancement.

【 授权许可】

   
2012 Vajro et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Cellini R, Pignataro G, Rizzo I: Competition and Efficiency in health care: an analysis of the Italian case. Int Tax Public Finance 2000, 7:503-519.
• [2]Tamburlini G: Migration of pediatric patients from Calabria region [in Italian]. Medico e Bambino 1997, 9:551-552.
• [3]Parisi F, Barone R, Procopio G, Miniero R: Health migration in the Calabria Region. Medico e Bambino 2012, 31:463-464. http://www.medicoebambino.com/?id=1207_463.pdf webcite
• [4]D’Andrea N: Migration of sick children [in Italian]. Salute e Territorio 1992, 80:31-33.
• [5]Grimaldi M, Greco L, Violino M, Ventura S, Alcaro P, D’Andrea N: South–north migration of pediatric patients in Italy. Attitudes of pediatricians of Southern Italian regions [in Italian]. Riv Ital Ped (IJP) 1983, 9:298-300.
• [6]García-Lacalle J, Bachiller P: Dissecting hospital quality. Antecedents of clinical and perceived quality in hospitals. Int J Health Plann Manag 2011, 26:264-281.
• [7]Geraedts M, Schwartze D, Molzahn T: Hospital quality reports in Germany: patient and physician opinion of the reported quality indicators. BMC Health Serv Res 2007, 7:157. BioMed Central Full Text
• [8]Cantarero D: Health care and patients’ migration across Spanish regions. Eur J Health Econ 2006, 7:114-116.
• [9]Ansell D, Schiff G, Dick S, Cwiak C, Wright K: Voting with their feet: public hospital, health reform, and patient choices. Am J Public Health 1998, 88:439-441.
• [10]Luft HS, Garnick DW, Mark DH, Peltzman DJ, Phibbs CS, Lichtenberg E, McPhee SJ: Does quality influence choice of hospital? JAMA 1990, 263:2899-2906.
• [11]Appleby J, Harrison A, Dewar S: Patients choosing their hospital. BMJ 2002, 326:407-408.
• [12]Propper C, Croxson B, Shearer A: Waiting times for hospital admissions: the impact of GP fundholding. J Health Econ 2002, 21:227-252.
• [13]Brouwer W, van Exel J, Hermans B, Stoop A: Should I stay or should I go? Waiting lists and cross-border care in the Netherlands. Health Policy 2003, 63:289-298.
• [14]Tessier G, Contandriopoulos A, Dionne G: Patient mobility for elective surgical interventions. Soc Sci Med 1985, 20:1307-1312.
• [15]Tai WT, Porell FW, Adams EK: Hospital choice of rural Medicare beneficiaries: patient, hospital attributes, and the patient-physician relationship. Health Serv Res 2004, 39(6 Pt 1):1903-1922.
• [16]Kanavos P, McKee M: Cross-border issues in the provision of health services: are we moving towards a European health care policy? J of Health Serv Res Pol. 2000, 5:231-236.
• [17]Hermans HE: Cross-border health care in the European Union: recent legal implications of ‘Decker and Kohll’. J Eval Clin Pract 2000, 6:431-439.
• [18]Greco L, Grimaldi M, Occhinegro A: South–north migration of sick children [in Italian]. Riv Ital Ped (IJP) 1985, 11:287-295.
• [19]Monod J: Chance and Necessity: An Essay on the Natural Philosophy of Modern Biology. Knopf, New York; 1971.
• [20]Colicelli C: Heath migration as a social problem [in Italian]. I quaderni di monitor Trimestrale dell’Agenzia Nazionale per i Servizi Sanitari Regionali 2012, 9:19-23.