1,721,149 research outputs found
Decentralization process of the NHS and evolution of inter-regional equity in health care in the period 2001-2012
No full textThe policies pursued both at the international and national levels have brought to the fore the concept of governance decentralization of health-care systems. In Italy, in particular, with the approval of legislative decree n. 56/2000 on fiscal federalism and the amendments to Title V of the Constitution (Const. Law n. 3/2001), the Regions have obtained wider political, administrative, organizational and management competencies also in health care. At the international level, several studies have examined the issue of equity in a decentralized health-care system. In the Italian context, this also involves the provision of essential levels of health care (LEAs) across Regions. Equity is a constitutional principle, pursued by the central level and monitored through the set of indicators of the “LEA Grid” (Griglia LEA). Starting from the “LEA Grid” indicators, through a multidimensional analysis by principal components, the study analyzes the evolution of inter-regional equity in the provision of health care (prevention, hospital care, outpatient care) between 2001 and 2012, when the process of health-care decentralization became more established. In line with the international literature, this analysis shows a significant inter-regional heterogeneity. In particular, it highlights: 1) an interregional differentiation with respect to the principal components defined “vaccination coverage”, “hospital care performance” and “outpatient care for the disabled”; 2) a persistent differentiation in “hospital care” between central-northern and southern regions; 3) a negative trend for the autonomous regions and provinces both in the provision of “hospital care” and “vaccination coverage”. The results of the study, innovative for equity dimensions explored and data available, justify the central government's intervention as guarantor of territorial equity with respect to the provision of health care
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Utilizzo degli archivi elettronici sanitari nella stima dell’associazione tra danno renale acuto e mezzo di contrasto iodato
No full textLe amputazioni non traumatiche degli arti inferiori associate alla patologia diabetica in Italia durante il 2005-2014: studio dell’andamento temporale e della variabilità geografica basato sull’utilizzo dei database amministrativi sanitari.
No full textIntegrated use of healthcare utilization databases: The Italian Legislative Decree on the interconnection of information flows
No full textMethods in childhood health: Chronic disease epidemiology and age estimation
No full textThis review reports the main results concerning two of the principal research topics of the Centre of Epidemiology, Biostatics and medical Information technology: epidemiology of type 1 diabetes, and statistical methods of age estimation. Our studies investigated the disease incidence, the time trend, the geographical patterns, the role of environmental factors, contributing to increase the knowledge of type 1 diabetes occurrence. Studying the determinants of disease management, the use of new technologies, patients’ quality of life and disease awareness, have provided useful information improving disease management. Statistical methods of age estimation were studied evaluating the performance of regression-based models assessing age in children. To overcome bias in age estimation of these models, a full Bayesian calibration method was developed. On-going research is developing aspects related to dietary intake, glycaemic variability, evaluation of therapeutic diagnostic paths and appropriateness of care in type 1 diabetes. Future studies will assess ethnic and racial differences in skeletal growth pattern and incorporation of multiple age predictors in the Bayesian calibration method to improve accuracy
Epidemiology of tetanus in the Marches Regions of Italy, 1992-95
No full textReported is incidence of tetanus in the Marches Region of Italy for the period 1992-95. Data were obtained from both the regional public health committee's notification forms for infectious diseases and from hospital clinical records. A total of 36 cases were examined, comprising 7 males (19.4%) and 29 females. The raw annual incidence was 6.3 per million population; the standardized incidence for females was four times greater than that for males (9.2 and 2.4 per million population annually, respectively). The patients' ages varied from 31 years to 88 years (median, 73.5 years). The incidence among subjects older than 65 years was approximately ten times greater than that among younger individuals. Chronic wounds, such as trophic lesions, represented the site of tetanus infection in 14.3% of cases whose infection entry point was identified. Treatment of the 36 cases required a total of 1239 hospital days, of which 58.7% were in intensive care and 29.6% were in infectious diseases departments. The raw annual mortality rate for the period considered was 0.7 per million population; the case-fatality ratio was 11%. The results of our study confirm the limits of the current Italian immunization programmes, which exclude a large portion of the population from antitetanus protection
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