Hospital admission for digestive diseases: Gastroenterology units offer a more effective and efficient care.

Background: Digestive diseases imply a substantial burden for health care systems. Effectiveness of specialized gastroenterology care has been demonstrated in a few real life surveys.

Aims: To perform an in-depth analysis of Hospital Discharge Records (HDRs) of patients admitted for digestive diseases (DDs) from all Italian regions over the years 2010-2014.

White paper of Italian Gastroenterology: delivery of services for digestive diseases in Italy: weaknesses and strengths.

In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999-2009, with more than 1,500,000 admissions/year; however only 5-9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.

Hospital care services for digestive diseases in Italy: the first quantitative assessment.

The scarcity of human and structural resources for specialized gastroenterology care is a problem in many Western countries. Data regarding the resources for Italian Gastroenterology, so far lacking, have been thus searched and evaluated. Based on an agreement protocol between the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) and the Ministry of Health, national data regarding all Institutions providing gastroenterological care were analysed.

Seasonal variations in injury rates in children: evidence from a 10-year study in the Veneto Region, Italy.

The objective of this study was to investigate the long term trend of pediatric injuries in Veneto Region (North-East of Italy) over 10 years, evaluating if seasonality in injury hospitalisations exists. Regional data on hospital admissions during the period 2000-2009 were analysed. Injury was defined as any condition identified by the International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM) codes 800-999, excluding late effects from injury (ICD-9-CM codes 905-909), and complications of surgical and medical care, not classified elsewhere (ICD-9-CM code 995-999) in the first diagnostic field.

Increasing incidence and mortality of infective endocarditis: a population-based study through a record-linkage system.

Background: Few population-based studies provide epidemiological data on infective endocarditis (IE). Aim of the study is to analyze incidence and outcomes of IE in the Veneto Region (North-Eastern Italy).

Methods: Residents with a first hospitalization for IE in 2000-2008 were extracted from discharge data and linked to mortality records to estimate 365-days survival.

Population-based analyses of radical cystectomy and urinary diversion for bladder cancer in northern Italy.

Objective: •To provide updated figures on urinary diversion, length of stay and mortality after cystectomy in two regions of northern Italy.

Patients And Methods: •Discharge records of patients undergoing cystectomy for bladder cancer in 2000-2008 were extracted from the regional archives of hospital discharges. •Data on partial vs radical cystectomy and type of urinary diversion were obtained from intervention codes.

Obstetric hospitalizations among Italian women, regular and irregular immigrants in North-Eastern Italy.

Objective: Italy has become an important host country for economic immigrants. The study is aimed at providing a descriptive analysis of obstetric hospitalizations among Italian and immigrant women in North-Eastern Italy.

Design: Population-based registry descriptive study.

Hospitalisation for surgical procedures is lower among immigrants than among non-immigrant preschool children: results from a region-wide study in Italy.

Background: Whether immigrant children receive unnecessary treatments and surgical procedures to a greater extent than non-immigrants remains controversial.

Objective: To investigate whether hospitalisation rates differ between immigrant and non-immigrant preschool children and the extent to which such differences relate to specific pathological conditions.

Methods: All discharges occurring to children aged 1-5 years between 2005 and 2007 in the Italian Region of Veneto (4.

Quality of care in congestive heart failure in the elderly: epidemiological evidence of a gap between guidelines and clinical practice.

Background And Aims: This study aimed at evaluating the quality of care in elderly patients hospitalized for heart failure, compared with that received by subjects of younger age.

Methods: A cross-sectional retrospective study was performed on hospitalized subjects for heart failure in the Veneto Region (4.5 million inhabitants), located in North-East Italy, for the year 2004.

A European project on incidence, treatment, and outcome of sarcoma.

Background: Sarcomas are rare tumors (1-2% of all cancers) of mesenchymal origin that may develop in soft tissues and viscera. Since the International Classification of Disease (ICD) attributes visceral sarcomas (VS) to the organ of origin, the incidence of sarcoma is grossly underestimated. The rarity of the disease and the variety of histological types (more than 70) or locations account for the difficulty in acquiring sufficient personal experience.

Trends from 1999 to 2007 in the surgical treatments of kidney cancer in Europe: data from the Veneto Region, Italy.

Objective: To investigate trends in the incidence of overall renal oncological surgery, and the trends and determinants of nephron-sparing (NSS) and minimally invasive surgery, in the Veneto region of North-eastern Italy.

Patients And Methods: The regional archive of hospital discharge records (HDRs) in the Veneto region of North-eastern Italy was assessed to identify discharged patients with a diagnosis of neoplasm of the kidney and intervention codes for partial nephrectomy (PN) or radical nephrectomy (RN) in 1999-2007. An indirect method for identifying minimally invasive surgery was also adopted.

Variability of adenoidectomy/tonsillectomy rates among children of the Veneto Region, Italy.

Background: Despite national guidelines in 2003 aimed at limiting the recourse to tonsillectomy and/or adenoidectomy (A/T), the latter are among the most frequent pediatric surgeries performed in Italy. Aim of the study is to investigate variability of A/T rates among children of the Veneto Region, Italy.

Methods: All discharges of Veneto residents with Diagnosis-Related Groups 57-60 and ICD9-CM intervention codes 28.

Seat belt use among rear passengers: validity of self-reported versus observational measures.

Background: The effects of seat belt laws and public education campaigns on seat belt use are assessed on the basis of observational or self-reported data on seat belt use. Previous studies focusing on front seat occupants have shown that self-reports indicate a greater seat belt usage than observational findings. Whether this over-reporting in self reports applies to rear seat belt usage, and to what extent, have yet to be investigated.

Feasibility of a screening programme for lung cancer in former asbestos workers.

Background: Low-dose computed tomography (CT) has been found to detect more Stage IA lung cancer than chest x-ray.

Aims: To investigate whether lung cancer screening with CT was effective and acceptable in former asbestos workers.

Methods: CT scanning was carried out following the protocol previously described in the literature.

Sustainability of the effects of the demerit points system on seat belt use: a region-wide before-and-after observational study in Italy.

To assess the short and long term effects of the demerit points system on seat belt use, we set a region-wide cross-sectional observational study 3 months before, and 3 and 15 months after the introduction of the scheme (July 2003) in the Veneto Region, Italy. We analysed differences in seat belt use by year of observation, gender and position in the vehicle, and obtained adjusted prevalence ratio (APR) through Poisson regression. A total of 29,303 drivers, 28,778 front and 12,186 rear passengers were observed.

Diffusion of good practices of care and decline of the association with case volume: the example of breast conserving surgery.

Background: Several previous studies conducted on cancer registry data and hospital discharge records (HDR) have found an association between hospital volume and the recourse to breast conserving surgery (BCS) for breast cancer. The aim of the current study is to depict concurrent time trends in the recourse to BCS and its association with hospital volume.

Methods: Admissions of breast cancer patients for BCS or mastectomy in the period 2000-2004 were identified from the discharge database of the Veneto Region (Italy).

Evidence-based policy on road safety: the effect of the demerit points system on seat belt use and health outcomes.

Objective: To assess the effect of a demerit points system, introduced in Italy in July 2003, on the prevalence of seat belt use (intermediate outcome) and the number of road traffic deaths and injuries (health outcomes).

Design: Pre- and post-intervention regional observational study for seat belt investigation (April 2003, October 2004); national time-series analysis of road traffic deaths and injuries between 1999 and 2004 for health outcomes.

Setting: Veneto region, Italy.

Pattern and determinants of hospitalization during heat waves: an ecologic study.

Background: Numerous studies have investigated mortality during a heatwave, while few have quantified heat associated morbidity. Our aim was to investigate the relationship between hospital admissions and intensity, duration and timing of heatwave across the summer months.

Methods: The study area (Veneto Region, Italy) holds 4577408 inhabitants (on January 1st, 2003), and is subdivided in seven provinces with 60 hospitals and about 20000 beds for acute care.

The choice between different statistical approaches to risk-adjustment influenced the identification of outliers.

Objective: Many statistical approaches have been applied to compare health care providers' performance, but few studies have examined how the outlier status of providers depends on the choice between risk-adjustment techniques.

Study Design And Setting: We analyzed the recourse to breast-conserving surgery (BCS) for breast carcinoma across 31 hospitals of the Veneto Region (Italy). The following methods were compared: the ratio of observed to expected events (O/E), regression models with provider effects introduced as dummy variables obtained by standard or weighted effect coding, and multilevel analysis.

Monitoring the occurrence of diabetes mellitus and its major complications: the combined use of different administrative databases.

Objective: Diabetes mellitus is a growing public health problem, for which efficient and timely surveillance is a key policy. Administrative databases offer relevant opportunities for this purpose. We aim to monitor the incidence of diabetes and its major complications using administrative data.