More than half a million Italians move from one region to another each year for medical care, creating a financial flow that reached €3.7 billion in 2019, mainly from the South to the North of the country. These figures emerge from a study published in the journal Papers in Regional Science and conducted by Giovanni Carnazza, a researcher in the Department of Economics and Management at the University of Pisa, in collaboration with Raffaele Lagravines, Paolo Liberati, and Irene Torrini from the Universities of Bari, Roma Tre, and Bocconi, respectively.
The team analyzed the phenomenon of healthcare mobility in Italy from 2002 to 2019. The results show that the South is the main exporter of patients, while the North is the primary beneficiary of healthcare resources.
The regions most affected by this "healthcare exodus" are Calabria, Campania, and Puglia, which lose significant sums of money to cover the medical expenses of their residents treated elsewhere. Conversely, regions such as Lombardy, Emilia-Romagna, and Veneto remain among the most sought-after destinations, with revenues exceeding €300 million annually. The central regions occupy an intermediate position: while Tuscany and Lazio attract patients, other regions like Umbria and Marche maintain a more balanced financial equilibrium.
In particular, Tuscany recorded a positive balance of approximately €139 million in 2019. The key factors behind this strong performance include: centers of excellence such as the Careggi University Hospital in Florence, the University Hospital of Pisa, and the Monasterio Foundation; high specialization in fields such as oncology, cardiac surgery, and transplants; and effective organizational management, with shorter waiting times compared to other regions.
"Healthcare mobility amplifies the North-South divide, draining resources from the South to the advantage of northern regions, which further improve their services—creating a vicious cycle of inequality in the national healthcare system," says Carnazza.
"The current system, based on redistributing resources according to healthcare mobility, penalizes poorer regions," Carnazza emphasizes. "From this perspective, it would be desirable to reform the funding model, adopting fairer criteria for allocating funds that take into account the actual healthcare needs of each region. Additionally, the state should regain greater control to ensure uniform levels of healthcare assistance across the country and prevent the quality of care from depending on one's postal code."
(Traslated by ChatGPT 4o)