scholarly journals Indirect impact of Covid-19 on hospital care pathways in Italy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Teresa Spadea ◽  
Chiara Di Girolamo ◽  
Tania Landriscina ◽  
Olivia Leoni ◽  
Silvia Forni ◽  
...  
Keyword(s):  
The Elderly ◽  
Malignant Neoplasms ◽  
Italian Population ◽  
Hospital Discharges ◽  
Effective Response ◽  
St Segment Elevation ◽  
Care Services ◽  
Italian Regions ◽  
And Performance ◽  
Set Up

AbstractEarlier in 2020, seven Italian regions, which cover 62% of the Italian population, set up the Mimico-19 network to monitor the side effects of the restrictive measures against Covid-19 on volumes and quality of care. To this aim, we retrospectively analysed hospital discharges data, computing twelve indicators of volume and performance in three clinical areas: cardiology, oncology, and orthopaedics. Weekly indicators for the period January–July 2020 were compared with the corresponding average for 2018–2019; comparisons were performed within 3 sub-periods: pre-lockdown, lockdown, and post-lockdown. The weekly trend of hospitalisations for ST-segment elevation myocardial infarction (STEMI) showed a 40% reduction, but the proportion of STEMI patients with a primary PTCA did not significantly change from previous years. Malignant neoplasms surgery volumes differed substantially by site, with a limited reduction for lung cancer (< 20%) and greater declines (30–40%) for breast and prostate cancers. The percentage of timely surgery for femoral neck in the elderly remained constantly higher than the previous 2 years whereas hip and knee replacements fell dramatically. Hospitalisations have generally decreased, but the capacity of a timely and effective response in time-dependent pathways of care was not jeopardized throughout the period. General trends did not show important differences across regions, regardless of the different burden of Covid-19. Preventive and primary care services should adopt a pro-active approach, moving towards the identification of at-risk conditions that were neglected during the pandemic and timely addressing patients to the secondary care system.

scholarly journals Monitoring the indirect impact of Covid-19 on hospital care pathways in Italy: results from the Mimico-19 network

2021 ◽  
Author(s):  
Teresa Spadea ◽  
Chiara Di Girolamo ◽  
Tania Landriscina ◽  
Olivia Leoni ◽  
Silvia Forni ◽  
...  
Keyword(s):  
Hospital Care ◽  
Elective Surgery ◽  
Time Dependent ◽  
Malignant Neoplasms ◽  
Care Pathways ◽  
Italian Population ◽  
Effective Response ◽  
St Segment Elevation ◽  
Italian Regions ◽  
Indirect Impact

Abstract The COVID-19 pandemic has a non-negligible indirect impact on hospital care pathways, which is important to estimate. To this aim, we set up the Mimico-19 network of seven Italian regions (62% of the Italian population) representing different socio-demographic areas of the country with also a different burden of the epidemic. We retrospectively analysed regional hospital discharges data, computing twelve indicators of volumes and performance in three clinical areas: cardiology, oncology and orthopaedics, including time-dependent pathways and elective surgery. Weekly indicators for the period January-July 2020 were compared with the average of the corresponding indicators in 2018 and 2019; comparisons were performed within 3 sub-periods: pre-lockdown, lockdown and post-lockdown. The weekly trend of hospitalizations for ST-segment elevation myocardial infarction (STEMI) showed a 40% reduction, but the proportion of STEMI patients with a primary PTCA did not significantly change from previous years. Volumes of malignant neoplasms surgeries differed substantially by site, with a limited reduction for lung cancer (<20%) and greater declines (30-40%) for breast and prostate cancers. Hospitalizations for femoral neck fracture in the elderly decreased by 20%, but the percentage of timely interventions remained constantly higher than the previous years. General trends did not show important differences across regions, regardless of the different Covid-19 burden. Hospitalizations have generally decreased, but the capacity of a timely and effective response in time-dependent pathways of care was not jeopardized throughout the period. The drop in the care demand for cardiovascular diseases and cancers needs to be further investigated and monitored more thoroughly.

Japan

2019 ◽  
pp. 45-54
Author(s):  
Yumi Shindo ◽  
Akira Homma
Keyword(s):  
Local Governments ◽  
Local Population ◽  
The Elderly ◽  
Dementia Care ◽  
Term Care ◽  
Care Services ◽  
People With Dementia ◽  
Care Workers ◽  
Educational Programmes ◽  
Set Up

There are two strengths of dementia care services available in Japan. One strength is the creation of the Integrated Community Care System, which aims to provide various services that the elderly might need within their areas of residence. It is the responsibility of local governments to set up the ICCS, because each community has different social resources, as well as differences in the local population and the number of elderly individuals. The other strength lies in the various educational opportunities in dementia available to medical and long-term care professionals. In 2001, the national government introduced educational programmes for care workers in the field of dementia care. In addition, educational programmes for medical doctors, managers of facilities/service centres for people with dementia, medical professionals working in hospitals, pharmacists, and dentists are currently provided under the government’s policies.

scholarly journals Mortality amenable to health care services and health inequalities across the regions of Italy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
Y Adja ◽  
C Reno ◽  
J Lenzi ◽  
M P Fantini
Keyword(s):  
Health Care ◽  
Mortality Rate ◽  
Health Services ◽  
Health Inequalities ◽  
Health Care Services ◽  
Care Quality ◽  
Amenable Mortality ◽  
Care Services ◽  
Italian Regions ◽  
And Performance

Abstract Background Amenable mortality is an indicator that measures the extent to which health services contribute to the improvement of the health of a population. It can also highlight geographical and socioeconomic inequalities. Therefore, it is used to assess quality and performance of health care systems, both at national and subnational level. The Italian National Health Service sets the essential levels of care (Livelli Essenziali di Assistenza, LEA), a health-benefit package for all citizens. Because every region is responsible for providing the LEA and can offer additional health care, monitoring the performance of the Regional Health Services (RHSs) is of increasing interest. Methods We used Nolte and McKee's list of amenable conditions to analyze the temporal trend of the standardized mortality rate (per 100.000) in Italy from 2006 to 2015, overall and by gender. We also examined the standardized rate at regional level by comparing the two-year periods 2006/7 and 2014/5, overall and by gender. Results Between 2006 and 2015, the overall mortality rate decreased from 81 to 68 per 100.000 population; this reduction was more pronounced in men (91 to 76 per 100.000, -16.5%) than in women (72 to 62 per 100.000, -13.9%). The decreasing trend in amenable mortality affected Italian regions differently, with northern regions showing steeper reductions as compared to southern regions. As a result, 2014/5 was the first time men's mortality in North Italy (68 per 100.000) was lower than women's mortality in South Italy (72 per 100.000). Conclusions The overall reduction of amenable mortality shows that Italy's health care services keep contributing to the improvement of population health. Nevertheless, by analyzing RHS performance we saw that differences in organization of care lead to differences in health care quality and performance across regions. Deaths amenable to health care services contribute to inequalities between Northern and Southern Italy. Key messages Because universal health coverage is necessary but not sufficient to reduce health inequalities, investing into better-quality services should be recognized as a priority. Amenable mortality can highlight areas of intervention to reduce inequalities in the provision of health care services.

Identification of determinants of healthy ageing in Italy: results from the national survey IDAGIT

2020 ◽  
pp. 1-21
Author(s):  
Erika Guastafierro ◽  
Ilaria Rocco ◽  
Rui Quintas ◽  
Barbara Corso ◽  
Nadia Minicuci ◽  
...  
Keyword(s):  
Neurological Diseases ◽  
Public Health Problem ◽  
The Elderly ◽  
Factor Loading ◽  
Healthy Ageing ◽  
World Health ◽  
Italian Population ◽  
Social Environments ◽  
Ageing Model ◽  
Health Organization

Abstract Healthy ageing is a public health problem globally. In Europe, the dependency ratio of the elderly is expected to increase by 21.6 per cent to 51.2 per cent in 2070. The World Health Organization (WHO) study on healthy ageing started in 2002 as a concept whereby all people of all ages should be able to live in a healthy, safe and socially inclusive way. The aim of this study is to present preliminary results of the project Identification of Determinants of Healthy Ageing in Italy (IDAGIT) that aimed to collect data on the active and healthy ageing of the Italian population aged over 18 using the conceptual framework of the WHO's ageing model. To link the determinants of the IDAGIT studies to those of the WHO model, we performed a confirmatory factor analysis which reported these variables as significant (in order of factor loading): smoking, cognition score, comorbidity, outdoor built environment, participation, working expertise and income. Considering comorbidity, 83.8 per cent of the sample declared not having any chronic diseases or to have only one, and regarding neurological diseases, only nine people had received a diagnosis of stroke. Regarding gender, the personal determinants and physical and social environments did not result in statistically significant differences, whereas we found statistical differences between the aged groups in all variables analysed. These results provide a first bio-psycho-social perspective on ageing in the Italian population.

scholarly journals Experiment Study on Performance of Air Source Heat Pump

2013 ◽  
Vol 805-806 ◽  
pp. 645-648
Author(s):  
Wei Xiu Shi ◽  
Li Sheng Pan
Keyword(s):  
Heat Pump ◽  
Temperature Difference ◽  
Heat Pumps ◽  
Outlet Temperature ◽  
Exhaust Temperature ◽  
Air Source Heat Pump ◽  
And Performance ◽  
Save Energy ◽  
C 30 ◽  
Set Up

Under the situation of energy crisis, air source heat pumps are paid more attention recently. In order to save energy, the feasibility and performance of air source heat pump are studied by experiment, and variation laws of exhaust temperature, evaporator outlet temperature and outlet presser of compressor were analyzed in this paper. Air source heat pump apparatus were set up and the experiment was during 10°C, 20°C, 30°C and 40°C. The results were as follows: exhaust temperature of compressor increases gradually with the increase of tank temperature, but the temperature difference between exhaust temperature of compressor and tank temperature becomes little; temperature difference in evaporator decreases; Compressor outlet pressure increases obviously.

The Fudan nuclear microprobe set-up and performance

2007 ◽  
Vol 260 (1) ◽  
pp. 109-113 ◽  
Author(s):  
L. Zhong ◽  
W. Zhuang ◽  
H. Shen ◽  
Y. Mi ◽  
Y. Wu ◽  
...  
Keyword(s):  
Nuclear Microprobe ◽  
And Performance ◽  
Set Up
Sign in / Sign up

Export Citation Format

Share Document