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A hub and spoke model to supply the Sicilian neurorehabilitation demand

Effects on hospitalization rates and patient mobility

Bibliographic Data

ID22067061
AuthorsAugusto Ielo (0000-0001-9661-9681, Centro Neurolesi Bonino Pulejo), Angelo Quartarone (0000-0003-1485-6590, Centro Neurolesi Bonino Pulejo), Rocco Salvatore Calabrò (0000-0002-8566-3166, Centro Neurolesi Bonino Pulejo, corresponding author), Maria Cristina De Cola (0000-0002-7509-3833, Centro Neurolesi Bonino Pulejo)
Year2024
Volume12
Pages1349211-1349211
Publication date2024-03-20
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2024.1349211
PMID38572007
OpenAlexW4393013931
LanguageEN
Citations received1
References cited17

Introduction: Cerebrovascular diseases in Sicily have led to high mortality and healthcare challenges, with a notable gap between healthcare demand and supply. The mobility of patients seeking care, both within and outside Sicily, has economic and organizational impacts on the healthcare system. The Hub and Spoke model implemented by the IRCCS Centro Neurolesi "Bonino-Pulejo" of Messina aims to distribute advanced neurorehabilitation services throughout Sicily, potentially reducing health mobility and improving service accessibility. Methods: The evaluation was based on calculating hospitalization rates, examining patient mobility across Sicilian provinces, and assessing the financial implications of neurorehabilitation admissions. Data from 2016 to 2018, covering the period before and after the implementation of the Hub and Spoke network, were analyzed to understand the changes brought about by this model. Results: The analysis revealed a significant increase in hospitalization rates for neurorehabilitation in the Sicilian provinces where spokes were established. This increase coincided with a marked decrease in interregional health mobility, indicating that patients were able to receive high-quality care closer to their residences. Furthermore, there was a decrease in both intra-regional and inter-regional escape rates in provinces within the Hub and Spoke network, demonstrating the network's efficacy in improving accessibility and quality of healthcare services. Discussion: The implementation of the Hub and Spoke network substantially improved neurorehabilitation healthcare in Sicily, enhancing both accessibility and quality of care for patients. The network's establishment led to a more efficient utilization of healthcare resources and balanced distribution of services. These advancements are vital steps toward equitable and effective healthcare delivery in Sicily

Business · Economic growth · Economics · Health care · Healthcare service · Medical emergency · Neurorehabilitation · Operations management · Physical therapy · Sicilian · Acute Ischemic Stroke Management · Engineering · Medicine · Telemedicine and Telehealth Implementation · Trauma and Emergency Care Studies · Rehabilitation

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    Open Access•Giovanni Guarducci, Davide Golinelli et al.•Frontiers in Public Health•2025

  • Toward social-health integration in Sicily

    Open Access•Maria Cristina De Cola, Augusto Ielo et al.•Frontiers in Public Health•2023

  • Patient mobility within national borders. Drivers and politics of cross-border healthcare agreements in the Spanish decentralized system

    Open Access•Roberta Perna, Gibran Cruz-Martínez et al.•Health Policy•2022

  • Hospitalization rates as indicators of access to primary care

    Open Access•Thomas C Ricketts, Randy Randolph et al.•Health & Place•2001

Unique citing works1
Citations per year1
Citation span2025 - 2025 (1)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 1

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