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. METHODS: Data on National HDRs were provided by the Italian Health Ministry. RESULTS: During the years 2010-2014, a mean of 949,830 patients with DDs were admitted to hospital per year, representing 10.0% of all admissions in Italy. Only 7.4% of patients with DDs were admitted to Gastroenterology units due to the limited number of the specialty-focused beds (3.4/100,000 inhabitants). DDs urgent admissions in Gastroenterology units represented 33% of admissions. The mean length of stay was 8.1 days in Gastroenterology units, as opposed to 8.3 in other units. Mortality rate for DDs altogether, for urgent admissions, and for urgent admissions with bleeding were 2.2%, 1.7%, 2.2% in Gastroenterology units, and 3.1%, 3.9%, 3.5% in other units, respectively. DDs admissions were appropriate in 81.3% in Gastroenterology units as opposed to 66.6% in all other units. CONCLUSIONS: Gastroenterology units offer a better specific care in terms of length of hospital stay and mortality even for patients admitted for emergent conditions.

Temporal and regional trends of choking injuries in children in Italy, 2001-2013.

BACKGROUND: Choking injuries in children are a significant public health problem. The present study was aimed at examining the epidemiologic patterns of choking injuries in children using Italian official data from hospital discharge records. METHODS: Hospital discharge records (from 2001 to 2013) reporting cases of choking injuries corresponding to the ICD-9 CM codes 933 ("Foreign body in pharynx and larynx"), 934 ("Foreign body in trachea, bronchus, and lung"), and fourth digit specifications (933.0 "pharynx", 933.1 "larynx", 934.0 "trachea", 934.1 "main bronchus", 934.8 "other specified parts", 934.9 "respiratory tree, unspecified") occurred in children aged 0-14 years were analyzed to assess the temporal and regional trends. Annual rates of hospitalizations due to choking injuries per 100,000 person-years were calculated and compared between boys and girls. RESULTS: During the 13-year study period, there were a total of 7143 hospitalizations due to choking injuries in Italian children. The annual rates of hospitalizations due to choking injuries per 100,000 person-years decreased from 5.28 in 2001 to 3.46 in 2013 (p < 0.001). The reduction in choking injuries occurred across all the regions, particularly in Campania, Lombardia, Puglia, and Veneto. CONCLUSIONS: Hospitalizations for choking injuries in Italian children have decreased significantly in recent years. Choking injuries in children remain a cause of concern in some regions. Future research needs to elicit the causal factors underlying the downward trends and regional variations and develop targeted interventions to further reduce choking injuries in Italian children.