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Home-based oncology palliative care is racing against time. In Florence, Italy—a city with approximately 364 073 inhabitants in 2024, with 990 527 in its metropolitan area1—a resolute team of four clinicians delivers critical care to a caseload averaging 1000 patients annually, many of whom require frequent home visits for symptom management and therapy adjustments. But what does it truly cost—both in time and human effort—to sustain this model of care in an era of dwindling resources and growing demand?
For the sake of curiosity—and with a dose of pragmatism—we quantified the daily operations of this team. The results were illuminating, if not alarming. Clinicians spend 43 min travelling and parking for each visit yet dedicate only 38 min to direct patient care (table 1). With a daily commute averaging 76 km, nearly half of their working hours are consumed by transit (figure 1).
Map of key locations in the Florence area, where the light blue nodes indicate the operational sites or key points within the network, the red nodes represent the major hospitals, the green node marks the main starting location where activities and movements are coordinated and the red numbers between the nodes indicate the distances travelled in kilometres (KM) connecting the various locations.
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Time allocation and …
Footnotes
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Contributors RG and GP were responsible for the conceptualisation and design of the manuscript, as well as the analysis and interpretation of the data, and the drafting of the text. RG took primary responsibility for the preparation of the figure and table. RG, GR and GP were actively involved in the critical review and final approval of the manuscript. All authors had unrestricted access to the data underpinning this study and collectively assumed responsibility for the decision to submit the manuscript for publication. RG serves as the guarantor, ensuring the integrity, accuracy and accountability of the work in its entirety. The figure illustrating the travel map of physicians was generated using AI tools to accurately represent the connections between operational sites, hospitals and the central headquarters. The process involved computational methods to map distances and visualise the relationships between the locations, ensuring clarity and precision in the presentation.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.