Assessing the impact of tourist flows on emergency department treatment speed for residents and tourists. The case of Sorrento

Tourism is a fundamental lever of the economic and cultural development of a location. Large tourist flows can negatively impact the provision of public services, such as healthcare. This study aims to investigate emergency department (ED) treatment speed under increased demand caused by tourism. The analysis was conducted on data (covering March–October 2018) collected from the ED of a hospital in Sorrento, a renowned coastal tourist destination in Campania, Italy, by using a two-step strategy. First, we resort to the Kaplan-Meier method to compare treatment in the ED between residents and tourists. Second, through the Cox proportional hazards model, we study the impact of group-specific characteristics on the speed of treatment. The main empirical findings highlight that treatment speed is highly influenced by age and by the languages spoken by tourists. Foreign tourists are best served in off-peak periods, while in the peak arrival period, the healthcare system experiences difficulties, especially for those facing higher language barriers. What emerges is the necessity for a tourism destination to adopt measures to cope with the language heterogeneity of tourists. In a multi-cultural touristic context, healthcare providers and institutions should address the challenge of language barriers by using specialist interpreter services.