The Diagnostic Accuracy and Clinimetric Properties of Screening Instruments to Identify Frail Older Adults Attending Emergency Departments: A Protocol for a Mixed Methods Systematic Review and Meta-Analysis.

Background: Prompt and efficient identification and stratification of patients who are frail is important, as this cohort are at high risk of adverse healthcare outcomes. Numerous frailty screening tools have been developed to support their identification across different settings, yet relatively few have emerged for use in emergency departments (EDs). This protocol provides details for a systematic review aiming to synthesize the accumulated evidence regarding the diagnostic accuracy and clinimetric properties of frailty screening instruments to identify frail older adults in EDs.

The Contribution of Case Mix, Skill Mix and Care Processes to the Outcomes of Community Hospitals: A Population-Based Observational Study.

Introduction: Community hospitals (CHs) could address the emerging complex care needs of patients. We investigated which characteristics of patients' and CHs affect patient outcomes, in order to identify who could benefit the most from CH care and the best skill mix to deliver this care.

Methods: We analysed all elderly patients discharged from the CHs of Emilia-Romagna, Italy.

Small-scale spatial distribution of COVID-19-related excess mortality.

Mortality due to massive events like the COVID-19 pandemic is underestimated because of several reasons, among which the impossibility to track all positive cases and the inadequacy of coding systems are presumably the most relevant. Therefore, the most affordable method to estimate COVID-19-related mortality is excess mortality (EM). Very often, though, EM is calculated on large spatial units that may entail different EM patterns and without stratifying deaths by age or sex, while, especially in the case of epidemics, it is important to identify the areas that suffered a higher death toll or that were spared.

Patterns of COVID-19 related excess mortality in the municipalities of Northern Italy during the first wave of the pandemic.

The impact of Coronavirus Disease 2019 (COVID-19) on mortality in Italy has been described at the regional level, while less is known about mortality in municipalities, although the spatial distribution of COVID-19 in its first wave has been uneven. We aimed to describe the excess mortality due to COVID-19 from February 23rd to April 30th, 2020 in the three most affected Italian regions, in age and gender subgroups within each municipality. Excess mortality varied widely among municipalities even within the same region; it was higher among the elderly and higher in males except in the ≥75 age group.

The Importance of Taking a Patient-Centered, Community-Based Approach to Preventing and Managing Frailty: A Public Health Perspective.

Across the world, life expectancy is increasing. However, the years of life gained do not always correspond to healthy life years, potentially leading to an increase in frailty. Given the extent of population aging, the association between frailty and age and the impact of frailty on adverse outcomes for older people, frailty is increasingly being recognized to be a significant public health concern.

What services should be guaranteed in universal health-care systems?

COVID-19 pandemic highlighted the importance of public, universal and equal access health-care, and reminded us that challenges are always incumbent for health-care systems. Because accessible and universal health-care systems will be critical into the future, it will be crucial to earmark adequate resources, fostering the financing of sectors that for many years have been neglected such as primary care and public health, and investments in new models of care and in health-related workforce.

Sociodemographic and health service organizational factors associated with the choice of the private versus public sector for specialty visits: Evidence from a national survey in Italy.

Introduction: Although Italy's NHS is funded through general taxation, the private sector plays an important role in health service provision and financing. The aim of this paper was to identify the sociodemographic and health service organizational factors associated with the propensity to seek specialist care in the private sector.

Materials And Methods: Data were retrieved from the national Istat survey "Health conditions and use of health services" carried out in 2012-2013.