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.

Keywords: Italy; cancer; delayed discharge; diagnosis-related groups (DRGs); elderly patients; home care services; hospitalization costs; infection; length of stay (LOS); simultaneous care.

背景： 在意大利，公共卫生投资未能跟上癌症护理需求的增长。住院费用增加，而住院时间（LOS）仍然是衡量医院效率和护理质量的关键指标。

方法： 一项生态学研究分析了2022年入住“Policlinico Tor Vergata”（罗马，意大利）的患者的出院记录。使用逻辑回归模型（AOR；95% CI）分析不同类型癌症与影响住院护理的关键变量之间的关联，并探讨了出院模式。

结果： 在14,451例普通住院病例中，癌症诊断占16.4%，其中血液系统肿瘤是最大的亚组（20.1%）。住院时间异常值（5%）导致额外的11,342个住院日。血液系统肿瘤与延长住院时间相关（2.031；1.499-2.753），而血液系统（2.368；1.911-2.933）、胃部（2.216；1.603-3.062）和膀胱癌（2.661；2.133-3.319）感染风险较高。患膀胱癌的患者更可能是≥65岁（2.661；2.133-3.319）。胃部癌症类型的二次诊断发生率更高（1.637；1.486-1.802）。出院分析显示，46.8%的癌症患者在没有激活家庭护理服务的情况下出院，而只有0.2%的患者接受了家庭护理激活。等待完成诊断或治疗过程时，癌症患者更可能在家外等候并最终出院（2.150；1.911-2.418）。

结论： 我们的研究结果强调了不同类型癌症住院模式的显著差异以及当前出院计划流程的不足。长期住院时间带来的负担突显了现有护理模型的不可持续性。迫切需要向综合、社区为基础的同时期护理模型过渡，以减少医疗成本，防止长时间住院，并改善结果，特别是对于脆弱的老年患者。

关键词： 意大利；癌症；延迟出院；疾病相关分组（DRGs）；老年患者；家庭护理服务；住院费用；感染；住院时间（LOS）；同时期护理。