Health mobility among the older adults in Italy: a regional inequality perspective

As Italy faces rapid demographic aging, understanding the healthcare mobility of older adults (over 65) has become a crucial challenge for regional planning and ensuring equitable access to care. This study examines interregional health migration among individuals aged 65 and over, shedding light on the patterns of elderly patients moving across Italian regions in search of hospital services. The main objective of this research aims to explore the determinants of health-related mobility for older adults and assess the territorial inequalities that drive these flows. Specifically, it investigates whether demographic factors, economic capacity, healthcare quality, and geographic proximity affect the direction and intensity of elderly patient mobility between regions. The analysis is based on integrated data from Istat, the Italian Ministry of Health, and AGENAS (National Agency for Regional Health Services). The methodological approach employs count gravity models (Poisson and Negative Binomial), with interaction effects between healthcare quality – measured through LEA (Essential Level of Care) scores – and economic development (GDP per capita) of the receiving regions. These models help to assess how both the performance of regional healthcare systems and the economic capacity of regions influence the decisions of elderly patients to move in search of medical care. Preliminary findings reveal significant disparities across regions. Older adults are more likely to move from Southern to Northern and Central regions, driven by better healthcare performance and infrastructure. The interaction between higher LEA scores and regional wealth strengthens a region’s attractiveness.