Health care costs and functional outcomes of road traffic injuries in the Lazio region of Italy.

The economic consequences of road traffic injuries (RTIs) are very important in terms of health care costs. The aim of this study is to provide estimates of health care costs of non-fatal RTIs and to estimate functional outcomes using in-hospital rehabilitation data. We identified all emergency department (ED) visits related to RTI during 2008 and then linked them with hospital discharges and rehabilitation admissions, health care costs following RTI were estimated from the integrated database. We performed an epidemiological evaluation of RTI with a comprehensive description of functional outcomes at 6 months. Health care costs have been estimated at about €80 million with a per person cost of €522. About 18% of the total cost was due to rehabilitation treatments. In multivariate analysis the variables that correlated better with higher total health care costs were: older age, injury severity, presence of spinal lesion. Patients requiring rehabilitation were: the elderly, patients suffering from a spinal cord injury and leg injuries. This study provides consistent health care cost estimates of RTI using administrative databases and it shows a picture of functional outcomes after RTI. Further research is needed for the estimation of other components of the total cost of RTI.

Use of health and social care services in a cohort of Italian dementia patients.

The aim of this study, conducted in the Region of Lazio, Italy, in 2008-2010, was to describe the use, over a one-year period, of health and social care services in a cohort of 712 patients with a diagnosis of dementia. These patients had never previously used such services. We evaluated the association between the patients' sociodemographic and clinical characteristics and their use of services. Sociodemographic and clinical data were collected at baseline using validated instruments, while the use of services was investigated at the end of the one-year follow-up through a structured (questionnaire-based) interview with the caregiver. We found that 11.9% of patients used health or social care services. The most frequent diagnoses were: Alzheimer's disease (72.1%), mixed dementia (20.5%), and vascular dementia (9.7%). A higher probability of use of services was observed in patients with: more than five years of schooling (OR=1.79; 95%CI:1.08-2.96); one or more comorbidity (OR=4.87; 95%CI:2.05- 11.57); severe (OR=4.78; 95%CI:1.75-13.06) or moderate dementia (OR=2.08; 95%CI:0.98-4.40). The low health and social care service use among dementia patients in this study could be explained by a lack of availability of services. Public health authorities should plan adequate networks of services, considering both patients and caregivers' needs.

[Estimating prevalence of diabetes mellitus in a Lazio province, Italy, by capture-recapture models]. / Stima di prevalenza di diabete mellito in una provincia del lazio attraverso i modelli cattura e ricattura.

OBJECTIVE: to estimate the prevalence of diabetes in a Lazio province, Italy, using a record linkage offour patient lists and applying capture-recapture techniques. DESIGN AND SETTING: we selected records of individuals living in Viterbo province (Lazio region, Italy) from four lists obtained from three different health administrative registries in 2004: the hospital discharge registry of Lazio region (ICD9-CM code 250, 2488 subjects); the registry of outpatient care prescriptions (subjects exempted from medical charge for health care related to diabetes, 3582 subjects); subjects with prescriptions of glicate haemoglobin (7169 subjects); the registry of exemptions, from medical charge for health care of the local health unit of Viterbo province, related to diabetes (8529 subjects). A deterministic record linkage using 5 different keys of linkage obtained from demographic information, was applied The estimates were derived using two capture-recapture techniques: log-linear models and sample-coverage approach. RESULTS: Record linkage results using the 5 different keys of linkage were similar. Prevalence estimates varied between 63% and 7.8% when all four lists were considered and they varied between 5.7% and 6.1% when the glicate haemoglobin list was excluded. CONCLUSIONS: Our estimates were slightly higher compared to those recently reported in the literature; estimates were particularly influenced by the inclusion/exclusion of the haemoglobin glicate prescriptions list. Estimates were not influenced either by the key of linkage, or by the capture-recapture technique. Health administrative registries can be used to estimate the prevalence of diabetes through record linkage and capture-recapture techniques. This approach leads to a reduction of time and costs compared with traditional health surveys.