The exodus of patients is costing 3.6 billion: in Lombardy and Emilia, over 100,000 hospital admissions outside the region

According to the latest report on inter-regional healthcare mobility, recently published by Agenas, there were 670,519 hospital admissions outside the region covered by regional health services in 2025, 5,360 fewer than in the previous year. The proportion of the total fell by just six hundredths of a percentage point, from 8.72 per cent to 8.66 per cent. The cost of hospital admissions remained at around 2.95 billion, whilst that of specialist outpatient care – that is, consultations and diagnostic tests – rose by almost 16 million to 665.4 million. Together, the two sectors monitored by Agenas amount to 3.62 billion. For those requiring treatment, however, distance matters just as much as regional boundaries. 56.9 per cent of planned hospital admissions outside the region take place in a neighbouring region. In the survey on journey times, 43.5 per cent fall into the category of over three hours. For out-of-region outpatient services, the figure rises to one in two.

Of the hospital admissions outside the region, 541,159 are planned. The remainder are either emergency admissions or take place in the region of domicile for people who live elsewhere. High-complexity hospital admissions account for around one-fifth of scheduled admissions and account for 55 per cent of their total cost, amounting to 1.3 billion. As a proportion of all inter-regional hospital admissions, their share has risen from 16.5 per cent to 17 per cent in one year, whilst their economic weight has increased from 43.1 per cent to 44.2 per cent. Accredited private healthcare providers account for almost 77 per cent of planned high-complexity hospital admissions outside the region. For rare or complex procedures, referring a patient to a specialist centre may be the appropriate choice. The approximately 427,000 planned admissions in the other categories – including those of medium and low complexity and groups at risk of inappropriate care – indicate, however, where it is necessary to check whether there are closer and more accessible alternatives available in a timely manner.

Lombardy and Emilia-Romagna combine strong appeal with planned outflow rates below the national average of 10.97 per cent. Lombardy receives almost 117,000 planned hospital admissions of non-residents and has an outflow rate of 6.61 per cent. Emilia-Romagna receives nearly 102,000, with a patient outflow rate of 8.68 per cent, and records the highest hospital turnover: 413 million compared with 382 in Lombardy. When specialist care is included, Lombardy rises to first place with 486 million, ahead of Emilia-Romagna (423) and Veneto (166). Liguria illustrates just how significant the differences are within the North. It has a scheduled patient outflow rate of 16.13 per cent and an overall deficit of almost 82 million.

In Southern Italy, Campania has the highest number of scheduled hospital discharges – over 55,000 – and the highest overall deficit, at almost 250 million. In Calabria, the deficit stands at 237 million and the scheduled patient loss rate is more than double that of Campania, at 23.13 per cent compared with 10.87 per cent. Next, in terms of total deficit, come Sicily and Puglia. Basilicata has an outflow rate of 32.64 per cent, and Molise 38.40 per cent. The latter, however, ends up with a surplus of 42 million across the two sectors. Revenue from treatment provided to those arriving from outside the region can therefore exceed the costs associated with those leaving, even where many residents are hospitalised elsewhere. To understand how many people leave because they struggle to find care, the economic flows and volumes of hospital admissions must be analysed alongside the type of service provided, the distance travelled and waiting times.

In the Centre region, Tuscany is in surplus in both hospital admissions and specialist care, whilst the Marche and Umbria regions are in deficit in both areas. Lazio offsets its hospital deficit with a surplus of 21 million in outpatient services. In scheduled admissions alone, admissions slightly exceed discharges – 40,770 compared with 39,449 – but their value is approximately 30 million lower.