20 Italian Hospitals Attract Patients from All Over Italy”

Listen to the audio version of the article

There is a “backbone” of large hospitals that guarantee the most complex treatments, attracting patients from all over Italy. A physiological phenomenon in a country like ours where many, too many, small hospitals still exist in large numbers: those with less than 120 beds are still over 150 and those with up to 400 beds around 200. What however remains “pathological” is the distribution of these maxi centers of excellence of our healthcare – between public and private affiliates – which are distributed disproportionately, concentrating mainly in the Center and North. A fact that encourages the so-called “journeys of hope”, that is, the movement of hundreds of thousands of patients who every year move mainly from the South to the North in search of the specialist care they need.

Confirmation of this imbalance comes from the map of the maxi poles developed by the technicians of the Ministry of Health and its Director of Programming Americo Cicchetti using the latest data from the SDO, the hospital discharge forms just published. Data with which a top 20 list of large hospitals was drawn up – not a “ranking” of the best performances, the ministry is keen to point out – which emerges after selecting the hospitals with the highest number of hospital discharges (11% of all the cases for ordinary hospitalization and day hospital) which is then assigned a score resulting from a mix of two indicators: the average weight of the DRG caseload (the complexity of the cases treated) and the attractiveness of patients arriving from other regions (the mobility ).

This map shows 5 hospitals in Lombardy (10 million inhabitants) in this list of 20 large top hospitals, three of which concentrated in Milan occupy the top positions for the highest “score” – Galeazzi, Humanitas of Rozzano (in the Milanese hinterland) and the Irccs San Raffaele – and only two structures for the whole of Southern Italy (for almost 20 million inhabitants), namely the Casa Relief of Suffering hospital in San Giovanni Rotondo (Puglia) and the Monaldi hospital of Naples. Also noteworthy in the top 20 are three hospitals in Tuscany – the Pisan hospital, the Sienese one and the Careggi in Florence – and three others in the Veneto (the university hospital in Verona, that in Padua and the Sacro Cuore Don Calabria hospital in Negrar ) and finally three in Rome, namely the Gemelli, the Biomedical Campus and the San Camillo Forlanini. But the striking fact is that if we also add the Mauriziano of Turin and the San Martino of Genoa, half of the large hospitals in the top 20 are all in the North, while 8 are in the Center (to the three in Tuscany and three in Rome are added the Sant’Orsola hospital in Bologna and the combined hospitals in Ancona) and only two in the South.

The report just published by the Ministry of Health on hospital discharges first of all points out how hospitalization activities have resumed after the decline during Covid when 6.817 million hospital discharges were recorded, rising in 2022 to 7.646 million and then touching 8 million in 2023 according to preliminary data (7.957 million). Returning to the topic of patient mobility in search of better care, the report always shows that as many as 8.3% of hospitalizations were carried out in a region other than that of the patient’s residence; the share returned to 2019 levels, after falling to 7.2% in 2020, with a slight recovery in 2021 (7.8%). This amounts to as many as 441 thousand hospitalizations outside the Region (considering only acute ones): thus ranging from 30.4% for Molise, 28.4% for Basilicata and 21.2% for Calabria to 5% for Lombardy, 5.4% in Emilia and 6.2% in Veneto. “This unfortunately shows that too many citizens, mainly from Southern Italy, still have to move to get the best care and face considerable economic and psychological costs”, warns the Minister of Health bitterly. Orazio Schillaci .