The residential healthcare for the elderly in Italy: some considerations for post-COVID-19 policies

The European Journal of Health Economics - In Italy, the COVID-19 pandemic and the death of many elderly people have put in evidence the uneven territorial distribution of nursing homes, which have...     

Studies on the epidemiology of child infections in the Bari area (South Italy) VII. Epidemiology of Epstein-Barr virus infections

Serological patterns against Epstein-Barr virus (EBV) specific antigens were determined in 3732 healthy babies and children aged 0–10 years living in the Bari area (South Italy).IgG antibodies against EBV capsid antigen (VCA) were found in 2713 subjects (72.7%). Seropositivity rates, high in the first semester of life (83.8%), declined between 6 and 12 months (65.6%) and even further between 1 and 2 years (43.8%). After 2 years the frequency of positive children rose progressively reaching steady levels between 5 and 7 years (80.2%) and between 8 and 10 years (81.9%).IgA antibodies against VCA, IgG anti-early viral antigen (EA) and IgG against virus-associated nuclear antigens (EBNA) were found in 17.9%, 15.9% and 25.7% of the subjects tested, respectively.IgM anti-VCA were found only in 35 (0.9%) children, but 818 (21.9%) exhibited antibody patterns suggestive of a recent infection: IgG anti-VCA 1:160 alone or in association with IgA anti-VCA or IgG anti-EA or both.These results suggest that in this area the primary infection by EBV occur early in life, with immunity to EBV acquired primarily after 4 years.     

Environmental monitoring and analysis of faecal contamination in an urban setting in the city of Bari (Apulia region, Italy): health and hygiene implications

Few studies have been conducted in Italy to quantify the potential risk associated with dynamics and distribution of pathogens in urban settings. The aim of this study was to acquire data on the environmental faecal contamination in urban ecosystems, by assessing the presence of pathogens in public areas in the city of Bari (Apulia region, Italy). To determine the degree of environmental contamination, samples of dog faeces and bird guano were collected from different areas in the city of Bari (park green areas, playgrounds, public housing areas, parkways, and a school). A total of 152 canine faecal samples, in 54 pools, and two samples of pigeon guano from 66 monitored sites were examined. No samples were found in 12 areas spread over nine sites. Chlamydophila psittaci was detected in seven canine and two pigeon guano samples. Salmonella species were not found. On the other hand, four of 54 canine faecal samples were positive for reovirus. Thirteen canine faecal samples were positive for parasite eggs: 8/54 samples contained Toxocara canis and Toxascaris leonina eggs and 5/54 samples contained Ancylostoma caninum eggs. Our study showed that public areas are often contaminated by potentially zoonotic pathogens.     

Asbestos hazards in the city of Rome, Italy

A review is made of asbestos as a health hazard, and attention is drawn to possible dangers due to exposure to asbestos in the city of Rome in and outside the work place. The exposure to asbestos of workers of the ATAC company (the public concern of urban passenger transport of Rome) is examined. This is particularly dangerous for workers who repair equipment with asbestos components, such as brake linings. Exposure to asbestos may also occur in inhabitants who live and work close to where asbestos fibres collect. The study evaluates the contamination of asbestos fibres in both work and urban environment among people directly or indirectly exposed to this pollutant.     

长沙市城乡老年人生活质量调查分析

目的调查长沙市城乡老年人生活质量的现状及其影响因素,为开展老年保健工作提供依据。方法采用问卷调查法,对2339名60～91岁老年人的生活质量进行调查,分析其性别、年龄、婚姻状况、家庭结构、文化程度、职业、常见慢性病、月收入等对老年人生活质量的影响。结果年龄、居住方式、婚姻状态、月收入和患慢性病情况不同的老年人生活质量总评分比较,差异有统计学意义（P〈0．01）,而性别、文化程度和职业不同的老年人生活质量总评分比较,差异无统计学意义。结论影响老年人生活质量的因素是多方面的,应针对影响因素采取有效的干预措施,以进一步提高老年人生活质量,实现“健康老龄化”。     

The financial crisis in Italy: implications for the healthcare sector

The global economic and financial crisis is having and impact on the Italian healthcare system which is undergoing a devolution process from the central government to regions and where about one third of the regional governments (mainly in the central and southern part of the country) are facing large financial deficits. The paper briefly describes the current macro scenario and the main responses taken to face the crisis and highlights the downside risks of introducing "linear" cuts in the allocation of resources. While justified by the risk of a national debt default, present fiscal policies might increase inequalities in access to care, deteriorate overall health indicators and population wellbeing, and sharpen existing difference in the quality of care between regions. Preliminary evidence shows that the crisis is affecting the quality of nutrition and the incidence of psychiatric disorders. During this difficult financial situation Italy is also facing the risk of a major reduction in investments for preventive medicine, Evidence Based Medicine infrastructures, health information systems and physical capital renewal. This cost-cutting strategy may have negative long term consequences Also, important achievement in terms of limiting waiting lists, improving continuity of care and patients' centeredness, and promoting integration between social and health care may be negatively affected by unprecedented resources' cuts. It is essential that in such a period of public funding constraints health authorities monitor incidence of diseases and access to care of the most vulnerable groups and specifically target interventions to those who may be disproportionally hit by the crisis.     

深圳市老年人生命质量及影响因素分析

目的 研究深圳市老年人生命质量及影响因素。方法 采用健康测量量表SF-36中文版,以随机方法抽取深圳市792名60岁常、暂住老年人进行问卷调查。结果 常住老年人生命质量得分(561.88±102.12)分,高于暂住老年人(520.40±95.42)分,常住老年人在躯体功能、躯体角色、总体健康、社会功能、心理卫生维度得分分别为(85.54±25.011),(60.42±55.991),(69.52±30.828),(79.61±34.307),(66.83±27.455)分,均高于暂住老年人(73.89±26.359),(52.41±55.040),(64.49±29.978),(58.04±28.939)分,差异有统计学意义(P<0.05);老年人生命质量的影响因素为患慢性病、年龄、个人经济收入、医疗费来源、婚姻状况、自理能力和居住状态。结论 深圳市老年人总体生命质量状况良好,常住老年人生命质量好于暂住老年人,患慢性病是老年人生命质量的最主要影响因素。     

The role of the Internet in improving healthcare quality

The Internet is a tool that has the potential to greatly affect and improve the quality of healthcare. This article discusses the ways in which the Internet is being utilized by healthcare administrators, physicians, and healthcare consumers to enhance the quality of care. Despite the Internet's growing popularity and use, several barriers remain that prevent its full implementation in the healthcare field. This article offers guidelines for administrators in using the Internet within their organizations.     

社区老年人慢性病患病现状及与生命质量关系

目的 了解福建省福州市社区老年人慢性病患病现状及其与生命质量的关系,为老年人慢性病防治和生命质量的改善提供科学依据.方法 采用分层随机抽样方法在福州市抽取12个社区共3 285名≥60周岁老年人进行问卷调查.结果 福州市3 285名社区老年人中,慢性病患病2 134例,慢性病患病率为64.96％,其中患1、2和≥3种慢性病者分别占57.12％、26.24％和16.64％;居于前10位的慢性病依次为高血压、糖尿病、冠心病、骨关节病、脑卒中、慢性胃肠病、白内障、慢性支气管炎、肺心病和恶性肿瘤,患病率分别为48.28％、19.06％、9.80％、4.02％、3.01％、2.56％、2.34％、2.25％、1.31％和0.85％;无慢性病老年人生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、活力(VT)、社会功能(SF)、情感功能(RE)、精神健康(MH)、生理健康(PCS)、心理健康(MCS)得分和生命质量总分均高于有慢性病老年人(P＜0.01);患不同数量慢性病老年人各维度得分间差异均有统计学意义(P＜0.05),患慢性病数量越多,各维度得分越低;患不同种类慢性病患者各维度得分间差异均有统计学意义(P＜0.01).结论 慢性病已严重影响福州市老年人的生命质量,患慢性病老年人的生命质量主要受所患疾病的种类及数量影响.     

Health-risk perception in the inner city community of Centro Habana, Cuba

Perceptions of health risks were surveyed in the inner city of Centro Habana, Cuba. A questionnaire developed by community leaders and experts was administered to 348 residents to determine the level of perceived risk for each of 41 risk items. Ecologic-level data on morbidity, mortality, and environmental indicators were also gathered. Using factor analysis to reduce the dimensionality of the data, five factor groupings accounted for 60% of the variance, as follows: social environment (40.8%); infectious agents and other health-risk factors of immediate concern (6.1%); lifestyle risks (4. 9%); environmental sanitation (4.1%); and living conditions (3.3%). A relationship between the perception of risk and the ecologic data was found, with inconsistencies largely attributable to factors known to influence risk perception. The greatest concern identified throughout the municipality was housing conditions, highest in the neighborhood that had already begun to address this problem. The analysis was useful in planning targeted health promotion campaigns and prioritizing further interventions. Repeat evaluation of risk perception will be conducted following the completion of interventions.     

马鞍山市城乡老年人口生活质量比较研究

目的 探讨马鞍山市城乡老人生活质量的差异及影响因素,为老年人口生活质量的改善提供科学依据。方法 以马鞍山市区及当涂县某乡镇作为本次研究现场,年龄≥60岁且无言语交流障碍者作为调查对象。现场调查采用一对一访谈形式进行问卷调查,调查工具包括一般社会人口学特征问卷、简版老年抑郁量表、社会支持量表和世界卫生组织生活质量测定简表。结果 城乡老人在性别、年龄、文化程度、慢性病、抑郁状况、社会支持等方面差异均有统计学意义 (P＜0.05)。农村老人生活质量总分及其4个领域得分均低于城市老人,城乡老人生活质量受到性别、年龄、慢性病、抑郁、社会支持等多种因素的影响 (P＜0.05),但是在影响因素种类和影响程度上有所差别。结论 城乡老人对改善生活质量的需求有所不同,应根据城乡老人不同特点进行干预以便有效地提高老人生活质量。     

Straight talk new approaches to healthcare. The healthcare quality equation

Though various health organizations may define and approach quality differently, the common denominator is the patient's perspective, experience and outcome. Quality issues should be an important part of health system executives' agenda. Successful quality programs have a number of key ingredients, including decision-reporting tools and business analytics information--which depend on robust information reporting and a system-wide electronic medical record--as well as highly motivated employees and physicians. In this installment of Straight Talk, representatives from two health systems--Kaiser Permanente and Clarian Health Partners--discuss their quality initiatives.     

Influenza vaccination among the elderly in Italy

This article surveys the attitudes and perceptions of a random sample of the elderly population in three regions of Italy on the use and efficacy of influenza vaccine. The data were collected by direct interviews using a standard questionnaire. The results show that vaccination coverage against influenza is inadequate (26-48.6%). The major reasons for nonvaccination were lack of faith in the vaccine and disbelief that influenza is a dangerous illness. These data emphasize the need for a systematic education programme targeted at the elderly and the provision of influenza vaccination, with the increased cooperation of general practitioners.     

Hospital expenditure for the elderly in Italy

The consequences of demographic and epidemiological transition have deeply involved the health care systems of western countries. Both the highest burden of care and the higher costs of in-patient services are due to the elderly patients. The aim of this paper is to evaluate the percentage of in-patient care due to the elderly patients and the role played by this care on affecting costs. To this purpose all the Italian 1996 discharge reports referred to in-patient care longer than one day, have been analysed. About 40% of in-patient care expenditure is due to over-65 patients while the percentage of the elderly of total Italian population is roughly 17%. The highest age-specific hospitalisation rate are due to cardiovascular and neurological diseases. Only 4 out of 30 most frequent DRGs among elderly patients are surgical pathologies, while the others are medical ones. The implementation of day-hospital care or out-of-hospital care addressed to the elderly will have to take in account these pathologies in order to be effective in both meeting treatment needs and reducing hospital expenditure.     

Air pollution and respiratory drug use in the city of Como,Italy

Study objective and setting Particulate air pollution has a known negative effect on human respiratory health, often studied with hospital admissions, emergency room access, or mortality as health indicators. We evaluate respiratory drug dispensing data as health indicators for the effects of total suspended particles (TSP) air pollution in the city of Como (84,713 inhabitants).Design Weekly count of individual patients with respiratory drug dispensed (Cases) and weekly dispensed daily defined doses (DDD) of drugs were modelled with weekly air mean concentrations of TSP using a Poisson regression model adjusted for long-term trends, seasonal variations, calendar variations due to holidays, and weather.Main result Relative risks (RR) were expressed for a variation from 10th to 90th percentile of TSP (29–92 g/m³). Weekly aggregation was used in consideration of the complexity of drug dispensing data and potential biases of daily aggregation. For weekly mean concentrations of TSP, RR=1.082 (95% Confidence level (CI) 1.002–1.169) for Cases and RR=1.137 (95% CI 1.044–1.238) for DDD.Conclusion Our study concludes that both Cases and DDD of dispensed respiratory drugs could be useful for epidemiological surveillance of air pollutant health effects. Further investigation may routinely allow health and economics considerations, producing a stimulating new tool for health policy makers.