Structural health inequalities and territorial disparities: drivers of healthcare migration

Abstract

Health-induced mobility is also tied to the distribution and availability of health care resources according to the regions and there is a balance between the supply and demand. Equity in access requires one to know the health profiles and needs of the population, so everyone gets an appropriate level of health treatment. The present study examines regional differences in the use of healthcare in Italy, particularly Medically Assisted Reproduction (MAR). Although, there has been improvement in MAR technologies, there are still inadequate public and private MAR centres in some places, and so many individuals must travel to undertake their treatments abroad as result of inequalities in service provision and regional policies. There is substantial financial burden on couples related to MAR, as travel, lodging and other costs can limit access, especially for those of lower income. To analyse these patterns in patient mobility, we utilise a finite mixture model using clustering techniques, which are widely used to analyse the population data. Results show that locally smooth General Mixture Models together with a normalised spectral cut-off criterion are good for clustering MAR related data. Notably, the migration toward Northern Italy is due to a larger presence of private centres, where generally more patients than public and/or accredited centres are treated. This seems to be shaped by rising demand for higher quality services and a strong preference for services from the private sector. These findings underscore the essential requirement for policy intervention to mitigate health access disparities and strengthen the resilience of health systems. District by district analysis of healthcare infrastructure is also essential in informing efforts to address this inequity in access to MAR services across the nation, and this inequity in the provision of MAR services has profound implications for both the reproductive rights of the individual, and broader demographic and socio-economic stability.