Background: In Italy, public health investments have not kept pace with the rising demand for cancer care. Hospitalization costs are increasing, and length of stay (LOS) remains a critical metric for hospital efficiency and care quality. Methods: An ecological study analyzed hospital discharge records of patients admitted to “Policlinico Tor Vergata” (Rome, Italy) in 2022. Associations between cancer types and key variables influencing inpatient care were analyzed using logistic regression models (AOR; 95% CI), along with discharge patterns. Results: Among 14,451 ordinary hospitalizations, cancer diagnoses accounted for 16.4%, with blood cancers as the largest subgroup (20.1%). LOS outliers (5%) contributed to 11,342 excess hospitalization days. Blood cancers were associated with prolonged LOS (2.031; 1.499–2.753), while blood (2.368; 1.911–2.933), gastric (2.216; 1.603–3.062), and bladder cancers (2.661; 2.133–3.319) had a higher infection risk. Patients with bladder cancers were more likely to be ≥65 years old (2.661; 2.133–3.319). Secondary diagnoses were more likely to occur in gastric cancer types (1.637; 1.486–1.802). A discharge analysis revealed that 46.8% of cancer patients were discharged home without activation of home care services, and only 0.2% received home care activation. Cancer patients were more likely to be discharged home (2.150; 1.911–2.418) while awaiting completion of diagnostic or therapeutic processes. Conclusions: Our findings highlight the significant variability in hospitalization patterns across cancer types and the inadequacy of current discharge planning processes. The burden of prolonged LOS highlights the unsustainability of current care models. An urgent transition toward integrated, community-based simultaneous care models is needed to reduce healthcare costs, prevent prolonged hospitalizations, and improve outcomes, particularly for vulnerable elderly patients.
背景：在意大利，公共卫生投资未能跟上癌症治疗需求的增长。住院费用持续上升，住院时长（LOS）仍是衡量医院效率与护理质量的关键指标。方法：本研究采用生态学方法，分析了2022年意大利罗马"托尔维加塔综合医院"的患者出院记录。通过逻辑回归模型（AOR；95% CI）结合出院模式，探讨了癌症类型与影响住院护理关键变量之间的关联。结果：在14,451例普通住院患者中，癌症诊断占16.4%，其中血液肿瘤占比最高（20.1%）。5%的LOS异常病例导致了11,342个超额住院日。血液肿瘤与住院时间延长显著相关（2.031；1.499–2.753），而血液肿瘤（2.368；1.911–2.933）、胃癌（2.216；1.603–3.062）和膀胱癌（2.661；2.133–3.319）具有更高的感染风险。膀胱癌患者中≥65岁的比例更高（2.661；2.133–3.319）。胃癌患者更易出现次要诊断（1.637；1.486–1.802）。出院分析显示，46.8%的癌症患者在未启动家庭护理服务的情况下出院返家，仅0.2%的患者启动了家庭护理。癌症患者在等待诊断或治疗流程完成期间更可能出院返家（2.150；1.911–2.418）。结论：本研究揭示了不同癌症类型住院模式的显著差异以及当前出院规划流程的不足。住院时间延长的负担凸显了现行照护模式的不可持续性。亟需向以社区为基础的整合式同步照护模式转型，以降低医疗成本、避免长期住院并改善预后，这对脆弱的老年患者群体尤为重要。
肿瘤(癌症)患者之家