OBJECTIVES:

To describe the hospital activity and mobility for radiotherapy, with particular focus on Gastroenteropancreatic neuroendocrine tumors (GEP-NET) patients, using the Hospital Information System (HIS) of Italy.

METHODS:

From HIS, which collects information related to all discharges from public and private hospitals in Italy, all radiotherapy hospitalizations (DRG 409) with discharge date between 2013 and 2019 were selected. Since there are no ICD-9-CM codes for GEP-NET, patients were identified by the presence of one of the following diagnoses: malignant neoplasm of liver, pancreas or endocrine gland.

The number of patients and volume of hospitalization were estimated by year, region and regimen: ordinary with length of stay ≤ 1 day (0-1), ordinary with length of stay ≥ 2 (2+) and day hospital (DH). Finally, an analysis of the interregional healthcare mobility has been conducted by estimating, for each region, the attraction and escape mobility indexes.

RESULTS:

13,500 patients per year were hospitalized for radiotherapy between 2013 and 2019: 72.2% of the hospitalizations in ordinary 2+ regimen, 6.3% in ordinary 0-1 and 21.5% in day hospital. A progressive reduction in the volume of hospitalizations was observed during the study period, both in ordinary regimes and in day hospital.

GEP-NETs patients with radiotherapy hospitalizations were 776 per year, for a total of 1,462 discharges: 93.5% in ordinary 2+ regimen and 3.3% both in ordinary 0-1 and DH.

Overall, the proportion of out-of-region GEP-NET hospitalizations for radiotherapy was equal to 57.4%, notably higher than mobility observed on average for acute admissions (8-10%).

CONCLUSIONS:

The analysis shows a reduction of radiotherapy hospitalization during the study period, underlining a still predominant use of ordinary regimes admission and a very high mobility. Moreover, the study wonders about the congruence of the coding system of HIS and the current technologies, also to evaluate the adequacy of reimbursement and hospital setting.